Romiplostim Cost Per Response In Itp Treatment In the Brazilian Health Care System

Abstract

Objectives: Systemic Lupus Erythematosus (SLE) is an autoimmune disease, characterized by periods of remissions and flares, with significant clinical and economic burden. The primary study objective was to estimate the 1-year direct medical cost for adult patients with active, autoantibody-positive SLE in Greece. MethOds: This is a national, multi-centre, retrospective study. Data were abstracted from patient records in 6 hospital centers specialized in SLE management. Starting with the patient with the most recent visit, patients with consecutive visits (backwards in time) were considered for inclusion, provided they met specific criteria. In order to estimate costs per disease severity, a stratification criterion was applied. Patient data were collected for a 1-year period starting from the inclusion date (January -September 2011) and moving forward. Data included patient characteristics and health care resource utilization. In addition, all SLE patients fulfilling the inclusion criteria and followed-up in the participating centers during a 3-month retrospective period were recorded. For cost calculation, official 2013 list prices were used. Results: 215 patients (30% severe according to the stratification criterion) were included in the study. Mean direct medical costs were estimated at € 1,225 for patients with non-severe and at € 3,741 for patients with severe active SLE. Laboratory and imaging tests, medicines, physicians' visits, and hospitalization costs represented 10.5%, 51.7%, 1.2%, 36.5% of mean cost respectively. Costs were statistically significantly higher for severe SLE patients. The total number of patients visiting the participating clinical sites during a 3-month period was 318 (19% with severe SLE). The weighted mean annual direct medical cost of SLE in Greece was estimated at € 1,703. cOnclusiOns: Direct medical cost of SLE in Greece is significant, especially for patients with severe disease. An estimation of indirect costs would provide a comprehensive picture of the societal burden of the disease.Objectives: Immune thrombocytopenia (ITP) is characterized by isolated thrombocytopenia with no underlying cause. It manifests clinically as mucocutaneous bleeding caused by decreased platelets. Recently, two thrombopoietin receptor-agonists have emerged as an important therapeutic options: romiplostim and eltrombopag. Since these medications have different mode of administration, safety and efficacy profiles, the present study was carried out in an attempt to investigate which drug would be more cost-effective in the Brazilian setting. The objective was to perform an economic analysis evaluating the cost per response of romiplostim versus eltrombopag in adult patients with chronic ITP and refractory to other treatments as corticosteroids and immunoglobulins in Brazil health care private system. MethOds: Two economic analyses were performed in order to study the use of romiplostim and eltrombopag for the treatment of adults with chronic refractory ITP, based on annual treatment costs and cost per ...

Cost-consequence model comparing eltrombopag versus romiplostim for adult patients with chronic immune thrombocytopenia

“…Several studies have assessed the cost per responder of ROMI, 7 – 10 although they did not compare these costs to EPAG and were not in a US setting. To date, there have been no head-to-head clinical trials comparing EPAG and ROMI, and few indirect treatment comparisons (ITCs) have been developed to assess the efficacy and safety of these therapies (eg, Allen et al 11 ).…”