Nonacog beta pegol (Refixia) for the treatment of hemophilia B


Nonacog beta pegol (trade name: Refixia) has been approved in Germany since June 2017 for the treatment of hemophilia B in people over the age of 12.

Hemophilia is an inherited disorder that affects the blood's ability to clot. Blood contains several components which cause blood to clot in order to prevent blood loss following injury. These components include a number of proteins called clotting factors. If some of these clotting factors are missing, the blood will clot more slowly or won't clot at all. As a result, even small cuts can lead to quite a lot of blood loss.

There are different types of hemophilia, each caused by the lack of a different clotting factor. In hemophilia B, the gene responsible for the production of factor IX (antihemophilic globulin B or Christmas factor) is defective. Depending on how severe the disease is, a substitute for clotting factor IX is needed in order to improve blood clotting. This clotting factor can be extracted from human blood or manufactured using biotechnology.

Nonacog beta pegol is a substitute for factor IX that is manufactured using biotechnology. It can be used in patients with congenital hemophilia B for the treatment or prevention of bleeding, for instance before a tooth extraction or surgery.


Nonacog beta pegol is injected into a vein. The dose of the drug and duration of treatment will depend on several factors, including the patient's weight and the severity of the condition. The degree of the bleeding and the kind of surgery that is planned play a role too.

Other treatments

A number of medications containing factor IX are already available for the treatment and prevention of bleeding in people with hemophilia B.


In 2018, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) wanted to look into the advantages and disadvantages of nonacog beta pegol when compared with other medications containing factor IX for the treatment of hemophilia B in people over the age of 12.

But the manufacturer did not provide any suitable data with which to do the assessment.

More information

This information summarizes the main results of a review produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The review was commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of the review and the hearings received, the G-BA passed a resolution on the added benefit of nonacog beta pegol (Refixia).

Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Nonacog beta pegol (hemophilia B) – Benefit assessment according to §35a Social Code Book V. Dossier assessment; Commission A17-57. January 26, 2018. (IQWiG reports; Volume 590).

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

Comment on this page

What would you like to share with us?

We welcome any feedback and ideas. We will review, but not publish, your ratings and comments. Your information will of course be treated confidentially. Fields marked with an asterisk (*) are required fields.

Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

Created on February 22, 2018
Next planned update: 2021


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

How we keep you informed

Follow us on Twitter or subscribe to our newsletter or newsfeed. You can find all of our films online on YouTube.