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...
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Published in | Rare (Amsterdam, Netherlands) Vol. 3; p. 100078 |
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Main Authors | , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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Elsevier B.V
2025
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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. |
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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 |
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Cites_doi | 10.1016/j.blre.2017.08.007 10.1111/joim.12504 |
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Keywords | SETH AAV5 RFVE GMOs SEDISA ANEH haemophilia B FIX SEHH FEDHEMO SECA NHS WFH Gene therapy LPRL patient journey roadmap |
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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 |
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Title | Proposal of an Integrated Patient Journey roadmap for the introduction of the first gene therapy for haemophilia B in Spain – The BHEMOGEN project |
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