Page 1 of 9

Please see ADVATE Indications and Detailed Important Risk Information.

Are you age 14 or older?

1Are you a hemophilia A patient or do you care for someone with hemophilia A?

2Please select your agethe age of the person you care for from the groups below.

3How long have youhas the person you care for been using ADVATE to treat yourhis hemophilia A?

4In total, how many FVIII infusions have youhas the person you care for completed using the ADVATE with BAXJECT III system?

5Which of the following best describes how youthe person you care for regularly treats yourhis hemophilia A?

6Typically, when administering factor, to the person you care for, how many vials do you put into 1 syringe?

7Overall, how satisfied are you with each of the following?

  Not at all satisfied 1 2 3 4 5 6 Extremely satisfied 7
The FVIII product youthe person you care for currently use uses (ADVATE)
ADVATE with BAXJECT III reconstitution system

8What is the likelihood that youthe person you care for will continue to use ADVATE in the next 12 months because of the BAXJECT III system?

Not at all likely 1 2 3 4 5 6 Extremely likely 7

9Please rate your overall assessment of the BAXJECT III system in comparison to BAXJECT II needleless reconstitution device for each of the following using a scale where 1 is Worse than BAXJECT II, 4 is the Same as BAXJECT II, and 7 is Better than BAXJECT II.

  Worse than BAXJECT II 1 2 3 Same as BAXJECT II 4 5 6 Better than BAXJECT II 7
Time to reconstitute and administer factor using the BAXJECT III reconstitution system
Overall experience with the BAXJECT III reconstitution system

10 Based on your experience using the ADVATE with BAXJECT III system, please rate your likelihood to share your experience with the ADVATE with BAXJECT III system with another hemophilia A patientcaregiver.

Not at all likely 1 2 3 4 5 6 7 8 9 Extremely likely 10

Thank you for your time and input

Have questions? Simply click the link below to get in touch with your dedicated Baxalta representative, or call 1-844-229-2582 to speak with customer service.

Connect with Your Rep
Stay up-to-date with ADVATE

This survey is designed for those who are 14 years or older. Please ask your caregiver to complete this survey.

Return to ADVATE.com

ADVATE [Antihemophilic Factor (Recombinant)] Important Information

Indications

  • ADVATE is a medicine used to replace clotting factor (factor VIII or antihemophilic factor) that is missing in people with hemophilia A (also called “classic” hemophilia).
  • ADVATE is used to prevent and control bleeding in adults and children (0-16 years) with hemophilia A.
  • Your healthcare provider may give you ADVATE when you have surgery.
  • ADVATE can reduce the number of bleeding episodes in adults and children (0-16 years) when used regularly (prophylaxis).

ADVATE is not used to treat von Willebrand disease.

DETAILED IMPORTANT RISK INFORMATION

You should not use ADVATE if you:

  • Are allergic to mice or hamsters.
  • Are allergic to any ingredients in ADVATE.

Tell your healthcare provider if you are pregnant or breastfeeding because ADVATE may not be right for you.

You should tell your healthcare provider if you:

  • Have or have had any medical problems.
  • Take any medicines, including prescription and non-prescription medicines, such as over-the-counter medicines, supplements or herbal remedies.
  • Have any allergies, including allergies to mice or hamsters.
  • Have been told that you have inhibitors to factor VIII (because ADVATE may not work for you).

Your body may form inhibitors to factor VIII. An inhibitor is part of the body’s normal defense system. If you form inhibitors, it may stop ADVATE from working properly. Consult with your healthcare provider to make sure you are carefully monitored with blood tests for the development of inhibitors to factor VIII.

You can have an allergic reaction to ADVATE.

Call your healthcare provider right away and stop treatment if you get a rash or hives, itching, tightness of the throat, chest pain or tightness, difficulty breathing, lightheadedness, dizziness, nausea or fainting.

Side effects that have been reported with ADVATE include: cough, headache, joint swelling/aching, sore throat, fever, itching, dizziness, hematoma, abdominal pain, hot flashes, swelling of legs, diarrhea, chills, runny nose/congestion, nausea/vomiting, sweating, and rash.

Tell your healthcare provider about any side effects that bother you or do not go away or if your bleeding does not stop after taking ADVATE.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see ADVATE full Prescribing Information.

USBS/34/14-0148a(1)-t