Haemophilia A treatment extended to moderates

Written by Jessica Bomford, July 31, 2025

More people will be eligible to use emicizumab, the only treatment currently available for haemophilia A that can be injected under-the-skin rather than into a vein.

NHS England has approved an extension of the use of emicizumab to include people who have moderate haemophilia A and have a more severe bleeding phenotype. Previously only adults and children with severe haemophilia A were eligible. You can read the guidance here.

Kate Burt, Chief Executive of the Haemophilia Society, said: ‘Extending the availability of emicizumab means more people with haemophilia A will have more treatment choices, which is a very positive development. Having a treatment which can be administered through an under-the-skin injection is an option that we know our members value and we’re very pleased that more people will now be eligible for this product and can discuss its suitability with their clinician.’

Emicizumab, which is also called Hemlibra, is a monoclonal antibody which mimics the function of VIII (8) and binds to factor IX (9) and X (10) to restore the blood clotting process for people with haemophilia A. Made by Roche, emicizumab is a prophylactic treatment, meaning it is used to prevent bleeds, and is initially administered once a week, which can drop to every two weeks or every four weeks, depending on the individual. It is a ready-to-use solution which is injected subcutaneously.

Andrew Varley’s two sons and father-in-law have moderate haemophilia and will be eligible to use emicizumab.

Andrew said: ‘This will be a game changer for my family. The boys’ grandad is in his mid-70s and cannot administer his factor anymore because of severe joint damage. Being able to use emicizumab will be a godsend for him. My youngest son is 10 and uses a Port-A-Cath, so I’m hoping he can transfer directly onto emi.’

‘It’s a major milestone that grandad, who’s been through so much with his haemophilia, has lived long enough to know that his grandson may never have to access a vein to treat his haemophilia.’

Currently around 68% of children and adults with severe haemophilia in the UK are treated with emicizumab, and this figure continues to rise. This extension in eligibility will make this treatment option available to people with moderate haemophilia who have more frequent bleeding or joint bleeds that need treatment, have pre-existing joint damage or are already on prophylaxis. It is also available to all children with levels below 3%. It’s estimated that about 100 people with moderate haemophilia in England will be eligible for this treatment. We expect this decision to be followed in Scotland, Wales and Northern Ireland fairly quickly.

If you are interested in switching to this treatment, talk to your consultant about your eligibility and the pros and cons of the decision.