Product selection issues in the management of hemophilia B.

Issues that may influence selection of a factor concentrate for treatment of patients with hemophilia B, including whether the product is derived from plasma or is of recombinant origin, costs, pharmacokinetic issues, and safety considerations, are discussed in this paper. Data in the published literature, advice from the medical team, and patient and family preferences, will also impact product choice. Plasma-derived and recombinant products have similar efficacy; however, recombinant concentrates are more expensive and have demonstrated lower post-infusion recovery, and plasma-derived concentrates may be perceived as less safe. Improvements in donor selection and testing, viral inactivation, and product purification have greatly reduced potential risks of plasma-derived products. It is expected that both recombinant and plasma-derived products will continue to be used worldwide in the treatment of hemophilia B.