Reply to "High-titre inhibitors in previously untreated patients with severe haemophilia A receiving recombinant or plasma-derived factor VIII: a budget-impact analysis" by Messori et al.

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Dear Sir, 
Messori et al.¹ usefully extend the application of decision analysis in assessing economic aspects of haemophilia care. Such analyses have an important role to play in the increasingly complex decision-making process for choosing the appropriate product for the right patient. We would, however, suggest that the assumption that mortality would be unaffected between the two groups is challengeable, given the effect of inhibitors on patients' mortality² in environments providing superior care to what is possible for the majority of patients enrolled in SIPPET.  [...]