Optimizing emicizumab-kxwh Dosing in Hemophilia A: How Accredo’s Patented Calculator Enhances Precision and Patient Care
A new era in hemophilia A treatment
In hemophilia care, precision is more than a clinical goal—it’s essential to achieving optimal outcomes. To support more personalized and effective treatment planning, Accredo® Specialty Pharmacy developed a patented digital tool that helps prescribers tailor dosing regimens for patients receiving prophylactic therapy with emicizumab-kxwh.
Formally known as the Alternate Dose Regimen Identification System, it’s a dosing calculator designed to support clinically sound, patient-centered dosing decisions and simplify regimen selection—especially in the context of weight-based dosing and fixed vial sizes.
Featured in a clinical poster at the 2025 National Bleeding Disorders Foundation (NBDF) Annual Conference, the dosing calculator is helping transform how emicizumab-kxwh is prescribed—bringing measurable benefits to patients, providers, and care teams.
Dosing calculator available through Accredo’s prescriber portal, visit www.MyAccredoPatients.com.
How the calculator supports personalized emicizumab-kxwh dosing
The calculator is a patented, pharmacist-developed tool that uses patient-specific data to model dosing options for emicizumab-kxwh. By plotting dose (mg) against frequency (days), it generates a personalized graph that reveals alternative regimens to the original prescription. These alternatives are expected to maintain therapeutic efficacy based on the established pharmacokinetics of emicizumab-kxwh—providing plasma concentrations associated with sustained clinical benefit. This empowers prescribers with greater flexibility and precision in treatment planning.
This innovation was built on foundational work introduced by Accredo in 2023, when clinicians began spotlighting the challenges of weight-based dosing and fixed vial sizes in emicizumab-kxwh therapy. That earlier publication emphasized the need for smarter, more efficient prescribing strategies to reduce waste and streamline treatment.
The dosing calculator represents the next evolution of that insight—transforming clinical challenges into a scalable, pharmacist-led solution that delivers measurable impact in real-world care.
Key Features
Designed with prescriber input, the calculator offers a range of features that support individualized treatment planning and simplify regimen selection. Key capabilities include:
- Patient-specific dosing graphs tailored to the individual’s care plan
- Color-coded equivalency zones for quick visual comparison
- Hover-over Q7D (every 7-day) equivalency to support standardization
- Up to four optimized vial combinations to minimize waste
- Cost comparison between regimens to support value-based care
This patented system is built to reduce medication waste, simplify treatment schedules, and support better outcomes—all while maintaining therapeutic efficacy.
Case Study: Enhancing efficiency, reducing waste
A real-world case study highlights the measurable impact of the dosing calculator. In the original regimen, a patient was prescribed 111 mg of emicizumab-kxwh weekly, dispensed as one 150 mg vial per dose.
While clinically effective, this approach resulted in 156 mg of unused medication per month—equating to over $22,000 in avoidable waste. The patient also faced four injections per month, increasing treatment burden.
Using the calculator, a specialist pharmacist identified an optimized regimen: 450 mg every 28 days, using one 150 mg vial and one 300 mg vial per dose. This alternative maintained therapeutic equivalence (Q7D equivalent: 1.51 mg/kg), eliminated waste entirely, and reduced injection frequency by 50%.
This case illustrates how the calculator can simplify treatment, reduce waste, and improve the patient experience—without compromising efficacy.
Figure 1. Clinical Comparison of Original and Optimized emicizumab-kxwh Regimens Using ADRIS
| Aspect | Original Regimen | Optimized Regimen (via ADRIS) |
|---|---|---|
| Dose | 111 mg weekly | 450 mg every 28 days |
| Vial Dispensing | 1 × 150 mg vial per dose | 1 × 150 mg + 1 × 300 mg vial |
| Injection Frequency | 4 injections per month | 2 injections per month |
| Monthly Waste | 156 mg | 0 mg |
| Monthly Cost of Waste | $22,632.48 | $0 |
| Therapeutic Equivalence | Q7D equivalent maintained | Q7D equivalent maintained (1.51 mg/kg) |
| Patient Impact | Higher injection burden, unnecessary waste | Simplified regimen, reduced burden, no waste |
Why this approach matters in clinical care
The dosing calculator was developed to address a persistent challenge in emicizumab-kxwh dosing for hemophilia A: the dosing calculator balances clinical precision with practical delivery. Rather than replacing clinical judgment, the calculator is designed to support prescribers by offering data-driven insights that complement their expertise—especially when navigating weight-based dosing and fixed vial sizes.
By identifying dosing regimens that use full vials and reduce injection frequency, the dosing calculator helps:
- Decrease dosing errors by eliminating the need for patients to draw partial vials—an approach shown to increase the risk of inaccurate dosing
- Improve patient adherence
- Simplify treatment schedules
- Minimize medication waste
- Streamline pharmacy operations
These benefits are especially meaningful in chronic, high-treatment conditions like hemophilia A, where even small gains in dosing efficiency can lead to significant long-term impact—for both patients and the healthcare system.
“ADRIS gives clinicians a smarter way to prescribe—one that respects both the science and the patient experience. It’s a tool that brings clinical precision and real-world practicality together in a way we haven’t seen before.”
— Lesley D'Albini, PharmD, Specialty Clinical Program Director
Smarter dosing, better support
The calculator is more than a dosing tool—it’s part of a comprehensive care model designed to improve outcomes for patients receiving emicizumab-kxwh for hemophilia A.
Available through Accredo’s prescriber portal (www.MyAccredoPatients.com), the dosing calculator connects providers with personalized tools and real-time support. It’s also backed by the Blood Disorders Therapeutic Resource Center (TRC), a team of specialty-trained pharmacists and clinicians who are experts in bleeding disorders and provide guidance throughout the treatment journey.
Together, MAP and the Blood Disorders TRC help ensure that Accredo delivers on its promise to support prescribers with tools that enhance efficiency, reinforce clinical decision-making, and prioritize patient-centered care.
As specialty pharmacy continues to evolve, tools like the dosing calculator represent the future of personalized medicine—where clinical insight meets real-world practicality to redefine what’s possible in hemophilia care.
Take the Next Step
- Access the NBDF 2025 poster study to explore the clinical data behind the emicizumab-kxwh dosing calculator (link available following the conference presentation)
- Or, if you're ready to begin optimizing emicizumab-kxwh dosing, register for MAP to access the dosing calculator and connect with the Blood Disorders TRC
