Proposal of an Integrated Patient Journey roadmap for the introduction of the first gene therapy for haemophilia B in Spain – The BHEMOGEN project

The approval of the first gene therapy for haemophilia B represents a disruptive innovation in its management. Its practical integration into the Spanish national healthcare system presents unique challenges and opportunities, requiring the development of a structured, coordinated and multidisciplin...

Full description

Saved in:
Bibliographic Details
Published inRare (Amsterdam, Netherlands) Vol. 3; p. 100078
Main Authors Álvarez-Román, MT, Bonanad, S, Herrera, C, López, MR, García-Diego, DA, García, S, Montoro, JB, Quintero, JP, Poveda, JL, Gil, A, Gómez, I, Cortés, I
Format Journal Article
LanguageEnglish
Published Elsevier B.V 2025
Subjects
Online AccessGet full text

Cover

Loading…
Abstract The approval of the first gene therapy for haemophilia B represents a disruptive innovation in its management. Its practical integration into the Spanish national healthcare system presents unique challenges and opportunities, requiring the development of a structured, coordinated and multidisciplinary patient journey roadmap to ensure high-quality patient care and outcomes measurement. A multidisciplinary panel of 10 experts was established. The project involved a literature review, structured questionnaires, individual interviews, practical exercises and validation of results by focus group with nominal group methodology. No specific patient journey for haemophilia B or for gene therapy were identified in Spain. Associated changes required for current treatment of haemophilia B were identified and proposals made: 1) selection of candidates to receive gene therapy involves individualised assessment of eligibility criteria by a multidisciplinary committee including additional profiles; 2) providing adequate training on gene therapy to healthcare professionals is a must to ensure quality of care; 3) the generation of a specific informed consent document and processes involving hepatology and psychology are essential, with the patient association playing a crucial role; 4) centres without prior practical experience in gene therapy must adapt specific areas to ensure correct preparation and administration; 5) short- and long-term patient follow-up should incorporate continuous monitoring of the patient's liver health and inclusion in registries for evaluation of outcomes.
AbstractList The approval of the first gene therapy for haemophilia B represents a disruptive innovation in its management. Its practical integration into the Spanish national healthcare system presents unique challenges and opportunities, requiring the development of a structured, coordinated and multidisciplinary patient journey roadmap to ensure high-quality patient care and outcomes measurement. A multidisciplinary panel of 10 experts was established. The project involved a literature review, structured questionnaires, individual interviews, practical exercises and validation of results by focus group with nominal group methodology. No specific patient journey for haemophilia B or for gene therapy were identified in Spain. Associated changes required for current treatment of haemophilia B were identified and proposals made: 1) selection of candidates to receive gene therapy involves individualised assessment of eligibility criteria by a multidisciplinary committee including additional profiles; 2) providing adequate training on gene therapy to healthcare professionals is a must to ensure quality of care; 3) the generation of a specific informed consent document and processes involving hepatology and psychology are essential, with the patient association playing a crucial role; 4) centres without prior practical experience in gene therapy must adapt specific areas to ensure correct preparation and administration; 5) short- and long-term patient follow-up should incorporate continuous monitoring of the patient's liver health and inclusion in registries for evaluation of outcomes.
ArticleNumber 100078
Author Cortés, I
Gil, A
García-Diego, DA
Herrera, C
Álvarez-Román, MT
Quintero, JP
López, MR
Gómez, I
García, S
Bonanad, S
Montoro, JB
Poveda, JL
Author_xml – sequence: 1
  givenname: MT
  surname: Álvarez-Román
  fullname: Álvarez-Román, MT
  organization: La Paz University Hospital, Madrid, Spain
– sequence: 2
  givenname: S
  surname: Bonanad
  fullname: Bonanad, S
  organization: La Fe University and Polytechnic Hospital, Valencia, Spain
– sequence: 3
  givenname: C
  surname: Herrera
  fullname: Herrera, C
  organization: Reina Sofía General University Hospital, Córdoba, Spain
– sequence: 4
  givenname: MR
  surname: López
  fullname: López, MR
  organization: Álvaro Cunqueiro University Hospital, Vigo, Spain
– sequence: 5
  givenname: DA
  surname: García-Diego
  fullname: García-Diego, DA
  organization: Spanish Federation of Haemophilia (FEDHEMO), Spain
– sequence: 6
  givenname: S
  surname: García
  fullname: García, S
  organization: La Paz University Hospital, Madrid, Spain
– sequence: 7
  givenname: JB
  surname: Montoro
  fullname: Montoro, JB
  organization: Vall d′Hebron University Hospital, Barcelona, Spain
– sequence: 8
  givenname: JP
  surname: Quintero
  fullname: Quintero, JP
  organization: Virgen del Rocío University Hospital, Sevilla, Spain
– sequence: 9
  givenname: JL
  surname: Poveda
  fullname: Poveda, JL
  organization: La Fe University and Polytechnic Hospital, Valencia, Spain
– sequence: 10
  givenname: A
  surname: Gil
  fullname: Gil, A
  email: agil@omakaseconsulting.com
  organization: Omakase Consulting, Barcelona and Madrid, Spain
– sequence: 11
  givenname: I
  surname: Gómez
  fullname: Gómez, I
  organization: CSL Behring S.A, Spain
– sequence: 12
  givenname: I
  surname: Cortés
  fullname: Cortés, I
  organization: CSL Behring S.A, Spain
BookMark eNqFkDtOAzEQQC0EEt8LUPkCCfZuNnYQDaDwEz8JqC3HHhOHjb2aNUjpuAOckJPgJRSIApr5ad5o9DbJaogBCNnlrM8ZH-7N-qgR-gUrqjxgTMgVslGMKtZjTIrVH_U62WnbWV4pSyZEOdog77cYm9jqmkZHdaDnIcEj6gSW3urkISR6EZ8xwIJi1HauG-oi0jQF6kPCaJ9N8jF0dDdzHttEHyFA16JuFl_rUw3z2Ex97TU9yiC9a3SOH69v9D5TR2fjq5vT8TVtMM7ApG2y5nTdws533iIPJ-P747Pe5c3p-fHhZc8Uw1L2HEg7ACtLWwo3qAZ8AlIMJkZaLpkoKm5H4JwEIaByfCi5rtgEbFVwa4Z6wsotUizvGoxti-BUg36ucaE4U51aNVOdWtWpVUu1GTpYQpA_e_GAqjXZkwHrMf-ubPR_4_u_cFP74I2un2DxH_wJsAGZvg
Cites_doi 10.1016/j.blre.2017.08.007
10.1111/joim.12504
ContentType Journal Article
Copyright 2025 The Authors
Copyright_xml – notice: 2025 The Authors
DBID 6I.
AAFTH
AAYXX
CITATION
DOI 10.1016/j.rare.2025.100078
DatabaseName ScienceDirect Open Access Titles
Elsevier:ScienceDirect:Open Access
CrossRef
DatabaseTitle CrossRef
DatabaseTitleList

DeliveryMethod fulltext_linktorsrc
Discipline Medicine
EISSN 2950-0087
ExternalDocumentID 10_1016_j_rare_2025_100078
S2950008725000225
GroupedDBID .1-
.FO
0R~
AALRI
AAXUO
AAYWO
ACVFH
ADCNI
ADVLN
AEUPX
AFJKZ
AFPUW
AFRHN
AIGII
AITUG
AJUYK
AKBMS
AKRWK
AKYEP
ALMA_UNASSIGNED_HOLDINGS
AMRAJ
APXCP
EBS
FDB
GROUPED_DOAJ
Z5R
6I.
AAFTH
AAYXX
CITATION
ID FETCH-LOGICAL-c2638-fe8d4ed83d37f4541be874bc8d1807251d9eff8e77e5f1681a50bed521dc6ab03
ISSN 2950-0087
IngestDate Thu Jul 31 00:16:08 EDT 2025
Sat Apr 12 15:21:53 EDT 2025
Tue Aug 26 16:32:11 EDT 2025
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Keywords SETH
AAV5
RFVE
GMOs
SEDISA
ANEH
haemophilia B
FIX
SEHH
FEDHEMO
SECA
NHS
WFH
Gene therapy
LPRL
patient journey roadmap
Language English
License This is an open access article under the CC BY-NC-ND license.
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-c2638-fe8d4ed83d37f4541be874bc8d1807251d9eff8e77e5f1681a50bed521dc6ab03
OpenAccessLink http://dx.doi.org/10.1016/j.rare.2025.100078
ParticipantIDs crossref_primary_10_1016_j_rare_2025_100078
elsevier_sciencedirect_doi_10_1016_j_rare_2025_100078
elsevier_clinicalkey_doi_10_1016_j_rare_2025_100078
PublicationCentury 2000
PublicationDate 2025
2025-00-00
PublicationDateYYYYMMDD 2025-01-01
PublicationDate_xml – year: 2025
  text: 2025
PublicationDecade 2020
PublicationTitle Rare (Amsterdam, Netherlands)
PublicationYear 2025
Publisher Elsevier B.V
Publisher_xml – name: Elsevier B.V
References Agencia Española de Medicamentos y Productos Sanitarios. CIMA. Hemgenix. Available from
Eversheds Sutherland-Salud Advisory. Aportaciones para una estrategia en terapia génica para el Sistema Nacional de Salud. 2022. Avialble from
Berntorp (bib2) 2016; 279
Committee for Medicinal Products for Human Use (CHMP). European public assessment report of Hemgenix®. 2022. Available from
Agencia Española de Medicamentos y Productos Sanitarios. Ficha técnica de Hemgenix® (etranacogén dezaparvovec). 2022. Available from
Konkle BA, Fletcher SN. Hemophilia B. 2000 Oct 2 [Updated 2024 Jun 6]. In: Adam MP, Feldman J, Mirzaa GM, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2025. Available from
Real Fundación Victoria Eugenia. Recomendaciones para el tratamiento de la hemofilia B. 2020. Available from
Google Scholar. Available from
.
Agencia Española de Medicamentos y Productos Sanitarios. CIMA. Zolgensma (onasemnogén abeparvove). Available from
Dolan, Benson, Duffy, Hermans, Jiménez-Yuste, Lambert (bib1) 2018; 32
10.1016/j.rare.2025.100078_bib9
10.1016/j.rare.2025.100078_bib5
10.1016/j.rare.2025.100078_bib6
10.1016/j.rare.2025.100078_bib7
10.1016/j.rare.2025.100078_bib8
10.1016/j.rare.2025.100078_bib10
Dolan (10.1016/j.rare.2025.100078_bib1) 2018; 32
10.1016/j.rare.2025.100078_bib3
10.1016/j.rare.2025.100078_bib4
Berntorp (10.1016/j.rare.2025.100078_bib2) 2016; 279
References_xml – volume: 279
  start-page: 498
  year: 2016
  end-page: 501
  ident: bib2
  article-title: Future of haemophilia outcome assessment: registries are key to optimized treatment
  publication-title: J. Intern. Med.
– reference: Agencia Española de Medicamentos y Productos Sanitarios. CIMA. Zolgensma (onasemnogén abeparvove). Available from:
– reference: Konkle BA, Fletcher SN. Hemophilia B. 2000 Oct 2 [Updated 2024 Jun 6]. In: Adam MP, Feldman J, Mirzaa GM, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2025. Available from:
– reference: Agencia Española de Medicamentos y Productos Sanitarios. CIMA. Hemgenix. Available from:
– reference: Google Scholar. Available from:
– volume: 32
  start-page: 52
  year: 2018
  end-page: 60
  ident: bib1
  article-title: Haemophilia B: where are we now and what does the future hold?
  publication-title: Blood Rev.
– reference: .
– reference: Eversheds Sutherland-Salud Advisory. Aportaciones para una estrategia en terapia génica para el Sistema Nacional de Salud. 2022. Avialble from:
– reference: Committee for Medicinal Products for Human Use (CHMP). European public assessment report of Hemgenix®. 2022. Available from:
– reference: Real Fundación Victoria Eugenia. Recomendaciones para el tratamiento de la hemofilia B. 2020. Available from:
– reference: Agencia Española de Medicamentos y Productos Sanitarios. Ficha técnica de Hemgenix® (etranacogén dezaparvovec). 2022. Available from:
– ident: 10.1016/j.rare.2025.100078_bib10
– volume: 32
  start-page: 52
  year: 2018
  ident: 10.1016/j.rare.2025.100078_bib1
  article-title: Haemophilia B: where are we now and what does the future hold?
  publication-title: Blood Rev.
  doi: 10.1016/j.blre.2017.08.007
– ident: 10.1016/j.rare.2025.100078_bib5
– volume: 279
  start-page: 498
  year: 2016
  ident: 10.1016/j.rare.2025.100078_bib2
  article-title: Future of haemophilia outcome assessment: registries are key to optimized treatment
  publication-title: J. Intern. Med.
  doi: 10.1111/joim.12504
– ident: 10.1016/j.rare.2025.100078_bib6
– ident: 10.1016/j.rare.2025.100078_bib4
– ident: 10.1016/j.rare.2025.100078_bib3
– ident: 10.1016/j.rare.2025.100078_bib8
– ident: 10.1016/j.rare.2025.100078_bib7
– ident: 10.1016/j.rare.2025.100078_bib9
SSID ssj0003307739
Score 2.2786355
Snippet The approval of the first gene therapy for haemophilia B represents a disruptive innovation in its management. Its practical integration into the Spanish...
SourceID crossref
elsevier
SourceType Index Database
Publisher
StartPage 100078
SubjectTerms Gene therapy
haemophilia B
patient journey roadmap
Title Proposal of an Integrated Patient Journey roadmap for the introduction of the first gene therapy for haemophilia B in Spain – The BHEMOGEN project
URI https://www.clinicalkey.com/#!/content/1-s2.0-S2950008725000225
https://dx.doi.org/10.1016/j.rare.2025.100078
Volume 3
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3NbhMxELZCuXBBIECUAvKBW7RRHNub3WODAhGiBaWt1NvKXtuiFdmsQorUnvoO8Aq8GE_CjO3drErETy-rxMp4NzOf7PHsNzOEvMpz5zhzJlEyzROhnEi0yFnCNFbPSp1iyhNkD9PZiXh3Kk97vR8d1tLFWg_Kq615JbexKoyBXTFL9j8s204KA_AZ7AtXsDBc_8nGH7HFwZfgTqoQ3fOlHwxW3sdEx1ir6LK_WiqzUHVLKjxDgroJlWMbmoA7A08QWyrbfsjKClzOT8ouljXGXVR_guGRo1rBtWFJcE_amMymBx_eTg_7MbLT9XnnSC4DR3Z_gUUZTETgJtG4E4zA1_YZ-_wVJK6S-XLhX-OzQDdu2dwTODxUAZmtJzuzq5X1LZM2Yd_3KD3hdYiRH8y7AY6QBh3ibb_l3OCyOMol5sLHbdpuGYvrOt-6Q4RgxflgBf9kgLdDnsgwtBG6UXn7CKfFWUfS1wmSd8jdEZxGWOfkjhs-h3Vy7HvWtc8R07MCk_Dmrba7QB235vgBuR_PI3Q_gOsh6dnqEfneAIsuHVUV3QCLRmDRCCwagUUBKRQsSrvAQmkc88CiCCwageV_3gEWnYAg9cCiP6-_UYAUbSBFI6Qek5M30-PXsyS270jKEazqibOZEdZk3PCxE1IwbbOx0GVmWDYEnTKTW-cyOx5b6ViaMSWH2hrwJ02ZKj3kT8hOtazsU0IleMFSp5wZq0WpRC5SOOjDUmJsKXPBd0m_0WhRhyotRUNfPC9Q_wXqvwj63yW8UXrR5B_DjlkARP4oJVup6J0Gr_Mvcs9uKbdH7uG3EO57TnbWqwv7AhzgtX7p4fcLZjOuaA
linkProvider Directory of Open Access Journals
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Proposal+of+an+Integrated+Patient+Journey+roadmap+for+the+introduction+of+the+first+gene+therapy+for+haemophilia+B+in+Spain+%E2%80%93+The+BHEMOGEN+project&rft.jtitle=Rare+%28Amsterdam%2C+Netherlands%29&rft.au=%C3%81lvarez-Rom%C3%A1n%2C+MT&rft.au=Bonanad%2C+S&rft.au=Herrera%2C+C&rft.au=L%C3%B3pez%2C+MR&rft.date=2025&rft.pub=Elsevier+B.V&rft.issn=2950-0087&rft.eissn=2950-0087&rft.volume=3&rft_id=info:doi/10.1016%2Fj.rare.2025.100078&rft.externalDocID=S2950008725000225
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2950-0087&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2950-0087&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2950-0087&client=summon