Coût par patient répondeur associé au traitement du purpura thrombopénique immunologique primaire par romiplostim et rituximab chez l’adulte en France

Chiche, Laurent; Perrin, Allison; Stern, L. William; Kutikova, Lucie; Cohen-Nizard, S.; Lefrère, François

doi:10.1016/j.tracli.2014.03.007

Cited by 5 publications

(2 citation statements)

References 16 publications

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“…It should be noted that the cost of the treatment remains a critical factor in determining the clinical treatment plan. Each patient treated with the standard rituximab dosage should receive a total dose of about 2800 mg [ 37 ]. The cost of the standard dose regimen of rituximab in treating ITP is about 10000-40000 USD per 4-infusion course [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy and Safety of Different Dosages of Rituximab for Adults with Immune Thrombocytopenia: A Systematic Review and Meta-Analysis

Dong

Yue

2021

BioMed Research International

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Background. Rituximab has been frequently used as a second-line treatment for patients with immune thrombocytopenia (ITP). The optimal dose and course of rituximab are uncertain. Methods. A comprehensive search for randomized controlled trials reporting the use of low-dose (100 mg) or standard-dose (375 mg/m2) rituximab in ITP treatment was conducted. Meta-analyses were performed on CRR (complete response rate), ORR (overall response rate), PRR (partial response rate), SRR (sustained response rate), infection rate, SB (significant bleeding) rate, and SAE (serious adverse event) rate. Results. A total of 12 studies were included, comprising 869 patients. Compared to the control group, rituximab treatment resulted in an obvious increase in CRR ( P < 0.00001 ), ORR ( P < 0.0001 ), and SRR at month 6 and 12 ( P = 0.0007 , P = 0.0003 ), without increasing the infection rate ( P = 0.12 ) and SAE rate ( P = 0.11 ). No significant differences in CRR (RR 1.61 vs. 1.42, P = 0.45 ), ORR (RR 1.26 vs. 1.49, P = 0.28 ), PRR (RR 1.25 vs. 1.00, P = 0.11 ), SRR at month 12 (RR 2.00 vs. RR 1.64, P = 0.54 ), infection rate (RR 0.85 vs. 1.46, P = 0.36 ), and SB rate (RR 0.14 vs. 1.19, P = 0.17 ) were found in subgroups of low dose and standard dose. Conclusion. Rituximab was effective and safe for adult patients with ITP. A low-dose rituximab regimen might be an effective alternative to the standard-dose regimen in ITP, as it showed similar CRR, ORR, and SRR at month 12 and was relatively safer with a lower cost.

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Section: Discussionmentioning

confidence: 99%

The Efficacy and Safety of Different Dosages of Rituximab for Adults with Immune Thrombocytopenia: A Systematic Review and Meta-Analysis

Dong

Yue

2021

BioMed Research International

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“…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 ).…”

Section: Introductionmentioning

confidence: 99%

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

Tremblay¹,

Dolph²,

Bhor

et al. 2018

CEOR

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BackgroundThrombopoietin-receptor agonists eltrombopag (EPAG) and romiplostim (ROMI) are treatment options for adults with chronic immune thrombocytopenia (cITP) who have had an insufficient response to corticosteroids or immunoglobulins.MethodsA cost-consequence model was developed to evaluate the costs relative to treatment success of EPAG, ROMI, and watch and rescue (W&R) in previously treated patients. The primary endpoint assessed was severe bleeding, derived from all identified phase III registered clinical trials. Health outcomes were compared via indirect treatment comparison. Costs incorporated in the model included drug and administration, routine care, rescue medications, bleeding-related adverse events, other adverse events, and mortality costs. A trial (26-week) time horizon was used, as certain endpoints used in the model were bound to within-trial results.ResultsIn the intent-to-treat (ITT) population, the overall estimated cost per patient for EPAG was US$66,560 compared to US$91,039 for ROMI and US$30,099 for W&R. Compared to the ITT population, the difference in cost between EPAG and ROMI was slightly greater in splenectomized patients (US$65,998 for EPAG compared to US$91,485 for ROMI) and slightly less in non-splenectomized patients (US$67,151 for EPAG compared to US$91,455 for ROMI), though the overall trend remained the same. When assessing cost per severe bleeding event avoided in the ITT population, EPAG dominated (less expensive, more effective) ROMI. Sensitivity analyses confirmed these results.ConclusionEPAG was preferred over ROMI in the treatment of cITP, largely driven by the reduction in severe bleeding events associated with its use.

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Cost-Effectiveness of Thrombopoietin Mimetics in Patients with Thrombocytopenia: A Systematic Review

et al. 2023

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Coût par patient répondeur associé au traitement du purpura thrombopénique immunologique primaire par romiplostim et rituximab chez l’adulte en France

Cited by 5 publications

References 16 publications

The Efficacy and Safety of Different Dosages of Rituximab for Adults with Immune Thrombocytopenia: A Systematic Review and Meta-Analysis

The Efficacy and Safety of Different Dosages of Rituximab for Adults with Immune Thrombocytopenia: A Systematic Review and Meta-Analysis

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

Cost-Effectiveness of Thrombopoietin Mimetics in Patients with Thrombocytopenia: A Systematic Review

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