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

Tremblay, Gabriel; Dolph, Mike; Bhor, Menaka; Said, Qayyim; Elliott, Brian; Briggs, Andrew

doi:10.2147/ceor.s177324

Cited by 9 publications

(14 citation statements)

References 25 publications

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“…Both romiplostim and eltrombopag are expensive, but cost-effectiveness studies of the two drugs are conflicting. 59,60 Defining treatment success and failure The goal of romiplostim treatment is bleeding prevention and optimizing patient quality of life. The target platelet count should be based on achievement of these treatment goals and is generally between 50 × 10 9 /l and 150 × 10 9 /l in most patients.…”

Section: Selection Of Thrombopoietin Receptor Agonist In Chronic Pedimentioning

confidence: 99%

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The role of romiplostim for pediatric patients with immune thrombocytopenia

Al‐Samkari

Grace

Kuter

2020

Therapeutic Advances in Hematology

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The thrombopoietin receptor agonists (TPO-RAs) are a class of platelet growth factors used to treat immune thrombocytopenia (ITP) in children and adults. Romiplostim is a peptide TPO-RA approved for over a decade to treat adults with ITP but was just recently US Food and Drug Administration approved to manage ITP in children 1 year of age and older who have had an inadequate response to corticosteroids, intravenous immunoglobulin, or splenectomy. Like the small molecule TPO-RA eltrombopag, romiplostim offers a high clinical response rate in pediatric patients with ITP, but requires use over an extended, and possibly indefinite, duration. This review is a critical appraisal of the role of romiplostim in pediatric ITP, discussing the safety and efficacy of this agent in clinical trials of children and adults and defining the patients most likely to benefit from romiplostim treatment. The treating hematologist is additionally provided guidance with treatment goals, dosing strategies, toxicity management, and indications for discontinuation.

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Section: Selection Of Thrombopoietin Receptor Agonist In Chronic Pedimentioning

confidence: 99%

“…Both romiplostim and eltrombopag are expensive, but cost-effectiveness studies of the two drugs are conflicting. 59,60…”

Section: Selection Of Thrombopoietin Receptor Agonist In Chronic Pedimentioning

confidence: 99%

The role of romiplostim for pediatric patients with immune thrombocytopenia

Al‐Samkari

Grace

Kuter

2020

Therapeutic Advances in Hematology

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“…Eltrombopag was found to be £40,261 ($50,501) less expensive in every non-splenectomized ITP patient during their lifetime and £88,904 ($111,516) less expensive in every splenectomized ITP patient [ 39 ]. Tremblay et al analyzed the cost of TRAs for patients treated in the USA [ 40 ]. According to this study the overall cost for eltrombopag is approximately $66,560 ($65,998 in splenectomized patients and $67,151 in non-splenectomized patients) and for romiplostim $91,039 ($91,485 in splenectomized patients and $91,455 in non-splenectomized patients) [ 40 ].…”

Section: Reviewmentioning

confidence: 99%

“…Tremblay et al analyzed the cost of TRAs for patients treated in the USA [ 40 ]. According to this study the overall cost for eltrombopag is approximately $66,560 ($65,998 in splenectomized patients and $67,151 in non-splenectomized patients) and for romiplostim $91,039 ($91,485 in splenectomized patients and $91,455 in non-splenectomized patients) [ 40 ]. Fust et al concluded that romiplostim is cost-effective related to eltrombopag with a slight difference [ 41 ].…”

Section: Reviewmentioning

confidence: 99%

Romiplostim and Eltrombopag in Immune Thrombocytopenia as a Second-Line Treatment

Bidika¹,

Fayyaz²,

Salib³

et al. 2020

Cureus

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Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by platelet count less than 100×10 9 /L and an increased risk of bleeding. The risk of bleeding increases in proportion with the degree of thrombocytopenia. Although several medications are used for primary thrombocytopenia treatment, refractoriness remains a concern. Romiplostim and eltrombopag, two relatively new drugs, have been shown to be successful in ITP treatment after standard treatment failure. The current guidelines recommend their use as a second-line treatment. In this article, we have tried to compare which of these two medications is the best option considering clinical effectiveness, cost-effectiveness, adverse effects, and the possibility of switching between them in case of ineffectiveness. The studies used in this article were found in the PubMed database. All the studies are limited to adults. Based on these studies, both medications seem to be a largely effective, safe option. Romiplostim appears to have slightly fewer adverse effects and higher costs. Switching between thrombopoietin receptor agonists (TRAs) is a successful way to overcome adverse effects and inadequacy according to the currently available literature. We believe that more detailed studies are needed to determine which of these drugs should be considered the first choice, to report long term efficacy and adverse effects, and to determine if treatment guidelines can change regarding the use of TRAs as first-line treatment.

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“…6 Limited data are available comparing results with different TPO-RAs, 7 although a cost-consequence modeling comparison supported a preference for eltrombopag over romiplostim, driven by a reduction in severe bleeding events. 8 Grace et al 9 We undertook a retrospective study using electronic health records (EHR) among adult patients with ITP treated with second-line therapies. Our primary objective was to examine treatment patterns with eltrombopag, romiplostim, rituximab, and splenectomy with a focus on platelet counts, bleeding-related episodes, thrombotic events, and use of rescue medication.…”

Section: Introductionmentioning

confidence: 99%