Psy25 a Pharmacoeconomic Evaluation of Romiplostim (Nplate) for the Treatment of Chronic Immune Thrombocytopenia (Itp)

Brosa, M.; Arocho, R; Gutierrez, Linda S.; Kutikova, Lucie

doi:10.1016/s1098-3015(11)72974-6

Cited by 5 publications

(2 citation statements)

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“…In Canada, a net cost impact model showed that romiplostim is less expensive to prepare and administer than IVIg and is associated with lower indirect costs from a Canadian healthcare perspective [ 33 ]. Romiplostim was also associated with lower cost per response over 6 months when compared with rituximab from the French national health system perspective [ 34 ] and when compared with SoC in Spain [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Cost Effectiveness of Romiplostim for the Treatment of Chronic Immune Thrombocytopenia in Ireland

Lee

Thornton

Hirst

et al. 2013

Appl Health Econ Health Policy

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BackgroundRomiplostim, a thrombopoietin receptor agonist (TPOra), is a second-line medical treatment option for adults with chronic immune thrombocytopenia (ITP). Clinical trials have shown that romiplostim increases platelet counts, while reducing the risk of bleeding and, in turn, the need for costly rescue medications.AimsThe objective of this study was to assess the cost effectiveness of romiplostim in the treatment of adult ITP in Ireland, in comparison with eltrombopag and the medical standard of care (SoC).MethodsA lifetime treatment-sequence cost-utility Markov model with embedded decision tree was developed from an Irish healthcare perspective to compare romiplostim with eltrombopag and SoC. The model was driven by platelet response (platelet count ≥50 × 109/L), which determined effectiveness and progression along the treatment pathway, need for rescue therapy (e.g. intravenous immunoglobulin [IVIg] and steroids) and risk of bleeding. Probability of response, mean treatment duration, average time to initial response and utilities were derived from clinical trials and other published evidence. Treatment sequences and healthcare utilization practice were validated by Irish clinical experts. Costs were assessed in € for 2011 and included drug acquisition costs and costs associated with monitoring patients and management of bleeding, as available from published Irish reimbursement lists and other relevant sources. Deterministic and probabilistic sensitivity analyses were conducted.ResultsRomiplostim treatment resulted in an average of 20.2 fewer administrations of rescue medication (IVIg or intravenous steroids) over a patient lifetime than eltrombopag, and 29.3 fewer rescue medication administrations than SoC. Romiplostim was dominant, with cost savings of €13,258 and €22,673 and gains of 0.76 and 1.17 quality-adjusted life-years (QALYs), compared with eltrombopag and SoC, respectively. Romiplostim remained cost effective throughout a variety of potential scenarios, including short-term TPOra treatment duration (1 year). One-way sensitivity analysis showed that the model was most sensitive to variation in the cost of IVIg and use of romiplostim and IVIg. Probabilistic sensitivity analysis showed that romiplostim was likely to be cost effective in over 90 % of cases compared with eltrombopag, and 96 % compared with SoC at a willingness-to-pay threshold of €30,000 per QALY.ConclusionsUse of romiplostim in the ITP treatment pathway, compared with eltrombopag or SoC, is likely to be cost effective in Ireland. Romiplostim improves clinical outcomes by increasing platelet counts, reducing bleeding events and the use of IVIg and steroids, resulting in both cost savings and additional QALYs when compared with current treatment practices.Electronic supplementary materialThe online version of this article (doi:10.1007/s40258-013-0044-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Cost Effectiveness of Romiplostim for the Treatment of Chronic Immune Thrombocytopenia in Ireland

Lee

Thornton

Hirst

et al. 2013

Appl Health Econ Health Policy

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“…options.InitialinvestigationshaveshownthattheTPOreceptoragonistromiplostimcanenablepatientstoreduceordiscontinueotherITPmedications [24],andmaythereforebea cost-effective treatment option for chronic ITP patients [25][26][27].…”

mentioning

confidence: 99%

A Retrospective Observational Single-Centre Study on the Burden of Immune Thrombocytopenia (ITP)

Bauer¹,

Baumann²,

Berger³

et al. 2012

Onkologie

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Background: German data on economic consequences of immune thrombocytopenia (ITP) are limited. Patients and Methods: A retrospective, observational study based on chart review of adult patients with a confirmed diagnosis of ITP was conducted at a German university hospital. Costs are presented from the hospital perspective. Results: Of 50 eligible patients, 45 could be classified by disease duration: 19 patients < 3 months (38%, newly diagnosed ITP), 12 patients ≥ 3 to < 12 months (24%, persistent ITP), 19 patients ≥ 12 months (38%, chronic ITP). Complications included 85 bleeding events in 43 patients, including 3 intracranial haemorrhages. Documented were 955 outpatient visits in 43 patients (86%) and 92 inpatient hospital admissions in 45 patients (90%). Of the 46 patients (92%) treated, all received corticosteroids, 25 (50%) intravenous immunoglobulin, and 7 (14%) further therapies. 12 patients (24%) underwent splenectomy. Average total direct medical costs (mean (standard deviation)) were 17,091 (18,859) per patient, 12,749 (11,663) in 17 newly diagnosed ITP patients with a 0.88-month (0.65 months) average disease duration, and 29,868 (29,397) in 13 chronic ITP patients with a 33.5-month (16.8 months) average disease duration. Inpatient stays were the main cost drivers. Conclusion: These data concerning current healthcare provision for ITP patients in Germany indicate considerable resource consumption and the need for more effective treatment options in individual patients.

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Cost-per-responder analysis comparing romiplostim to rituximab in the treatment of adult primary immune thrombocytopenia in Spain

López

Mingot

Valcárcel

et al. 2015

Medicina Clínica (English Edition)

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Psy25 a Pharmacoeconomic Evaluation of Romiplostim (Nplate) for the Treatment of Chronic Immune Thrombocytopenia (Itp)

Cited by 5 publications

References 0 publications

Cost Effectiveness of Romiplostim for the Treatment of Chronic Immune Thrombocytopenia in Ireland

Cost Effectiveness of Romiplostim for the Treatment of Chronic Immune Thrombocytopenia in Ireland

A Retrospective Observational Single-Centre Study on the Burden of Immune Thrombocytopenia (ITP)

Cost-per-responder analysis comparing romiplostim to rituximab in the treatment of adult primary immune thrombocytopenia in Spain

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