A Comment on Boyers et al.: “Eltrombopag for the Treatment of Chronic Immune or Idiopathic Thrombocytopenic Purpura: A NICE Single Technology Appraisal”

Allen, Rachel; Brainsky, Andrés; Grotzinger, Kelly M.; Roccia, Tito

doi:10.1007/s40273-012-0003-8

Cited by 6 publications

(5 citation statements)

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“…To date, no head-to-head trials have compared EPAG and ROMI and few indirect treatment comparisons have assessed their relative efficacy and safety. 13 Several studies have assessed the cost of ROMI per patient who responded to treatment. 14 – 16 However, these studies did not consider pediatric patients in a US setting and costs were not compared to the costs for EPAG treatment.…”

Section: Introductionmentioning

confidence: 99%

Cost-consequence model comparing eltrombopag and romiplostim in pediatric patients with chronic immune thrombocytopenia

Tremblay¹,

Dolph²,

Bhor³

et al. 2018

CEOR

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BackgroundImmune thrombocytopenia (ITP) is an auto-immune disorder characterized by enhanced platelet destruction and, subsequently, the potential for increased bleeding. Thrombopoietin receptor (TPO-R) agonists have recently emerged as promising therapies for ITP patients who are refractory to other treatments. While eltrombopag (EPAG) is the only TPO-R agonist US Food and Drug Administration approved for use in pediatric patients, romiplostin (ROMI) has been used in Phase III clinical studies.MethodsA cost-consequence model (CCM) was developed to evaluate the costs of EPAG, ROMI, and watch-and-rescue (W&R) in relation to their respective treatment outcomes in previously-treated pediatric chronic ITP (cITP) over a 26-week time horizon. The costs of drugs, administration, routine care, rescue medications, adverse events, and mortality were included. Data on platelet count response rate, bleeding events, and adverse events were derived from all relevant identified Phase III-registered clinical trials, health outcomes were compared via indirect treatment comparison.ResultsThe overall estimated cost of EPAG per patient was US$66,550, compared to US$101,056 for ROMI and US$32,720 for W&R. EPAG’s lower cost compared to ROMI was largely due to lower drug costs (US$62,202 vs US$84,396), administration costs (US$0 vs US$1,955), and significantly lower costs due to severe bleeding (US$354 vs US$10,191). When assessing cost per severe bleeding event avoided, EPAG was dominant over ROMI (less expensive and more effective). EPAG was again dominant over ROMI when assessing the cost per responder and per bleeding event (any grade). Sensitivity analysis was consistent with the base case findings.ConclusionEPAG was the preferred TPO-R agonist to treat cITP when indirectly compared to ROMI, largely driven by its favorable severe bleeding outcomes and lower drug and administration costs.

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Section: Introductionmentioning

confidence: 99%

Cost-consequence model comparing eltrombopag and romiplostim in pediatric patients with chronic immune thrombocytopenia

Tremblay¹,

Dolph²,

Bhor³

et al. 2018

CEOR

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“…Noi (gli autori) riceviamo con piacere questa lettera di chiarimenti da parte di Allen et al [1]. Desideriamo giustificare l'utilizzo dei dati alternativi (precedenti), che sono stati presentati, per il fatto che essi erano i soli dati pubblicamente disponibili al momento della stesura dell'articolo e della sua accettazione per la pubblicazione [2].…”

Section: Gentile Editorunclassified

Risposta degli Autori ad Allen et al.: “Un commento a Boyers et al.: ‘Eltrombopag per il trattamento della porpora trombocitopenica immune o idiopatica cronica: valutazione di tecnologia singola presso il NICE’ ”

Boyers

Jia

Jenkinson

et al. 2013

PharmacoEcon Ital Res Artic

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“…We (the authors) acknowledge and welcome this letter of clarification from Allen et al [1]. We would like to justify our use of the alternative (earlier) data, which were presented on the grounds that these were the only publicly available data at the 'time of writing' and indeed acceptance of the article for publication [2].…”

Section: Dear Editormentioning

confidence: 98%

The Authors’ Reply to Allen et al.: “A Comment on Boyers et al.: ‘Eltrombopag for the Treatment of Chronic Immune or Idiopathic Thrombocytopenic Purpura: A NICE Single Technology Appraisal’”

et al. 2012

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A Comment on Boyers et al.: “Eltrombopag for the Treatment of Chronic Immune or Idiopathic Thrombocytopenic Purpura: A NICE Single Technology Appraisal”

Cited by 6 publications

References 4 publications

Cost-consequence model comparing eltrombopag and romiplostim in pediatric patients with chronic immune thrombocytopenia

Cost-consequence model comparing eltrombopag and romiplostim in pediatric patients with chronic immune thrombocytopenia

Risposta degli Autori ad Allen et al.: “Un commento a Boyers et al.: ‘Eltrombopag per il trattamento della porpora trombocitopenica immune o idiopatica cronica: valutazione di tecnologia singola presso il NICE’ ”

The Authors’ Reply to Allen et al.: “A Comment on Boyers et al.: ‘Eltrombopag for the Treatment of Chronic Immune or Idiopathic Thrombocytopenic Purpura: A NICE Single Technology Appraisal’”

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