Can a teenager with severe hemophilia study abroad safely?

Question

Hi doctor,

Our 17-year-old son, who has severe hemophilia A, is considering a study abroad program in a developing country with potential travel to neighboring regions. He is currently well-managed on an extended half-life factor product with weekly infusions. However, we have serious concerns about access to factor replacement therapy and emergency care abroad.

His hematologist has not provided a definitive recommendation regarding the safety of participating, citing uncertainty around international factor availability. Insurance coverage for overseas factor products is also unclear, despite the medical necessity.

We are exploring whether switching to Emicizumab prior to departure would offer a safer and more practical option, given its longer half-life.

Is it feasible to transport a 4-month supply with appropriate storage?
Could the factor be shipped internationally and safely, and what legal barriers might arise?
Are there international hemophilia treatment centers (HTCs) or WFH (World Federation of Hemophilia) resources to assist with care abroad?

Beyond the standard physician travel letter, we are seeking advice on specific emergency planning steps. What specific emergency planning beyond the standard travel letter is needed? Please provide a balanced approach supporting independence while ensuring appropriate medical access.

Please help me.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

It is important to consult with a local hematologist in the country your son is planning to visit and keep regular contact with them throughout his stay. Switching to Emicizumab is a reasonable and often effective option for individuals with severe hemophilia A, especially for those studying or living abroad. If your son is considering this, it would be best to start the transition well before departure to monitor how he responds and ensure it provides sufficient bleed protection.

In most cases, Emicizumab works well when properly dosed, and it reduces the need for frequent infusions and access to factor concentrates, making it more practical in settings where factor supply is uncertain.

Stay in contact with a local hematologist in the destination country in case of emergencies or for ongoing support.
If possible, ask your current hematologist to connect directly with their counterpart abroad to share your son’s treatment plan and ensure continuity of care.
Travel with an ample supply of factor, if feasible, as a backup for breakthrough bleeds, particularly if Emicizumab is not fully effective alone.

If you need any more clarification or help with your questions, feel free to ask.

Thank you.