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Cost-consequence model comparing eltrombopag versus romiplostim for adult patients with chronic immune thrombocytopenia
BACKGROUND: Thrombopoietin-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. METHODS: A cost-consequence model was developed to evaluate...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove Medical Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6219311/ https://www.ncbi.nlm.nih.gov/pubmed/30464563 http://dx.doi.org/10.2147/CEOR.S177324 |
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author | Tremblay, Gabriel Dolph, Mike Bhor, Menaka Said, Qayyim Elliott, Brian Briggs, Andrew |
author_facet | Tremblay, Gabriel Dolph, Mike Bhor, Menaka Said, Qayyim Elliott, Brian Briggs, Andrew |
author_sort | Tremblay, Gabriel |
collection | PubMed |
description | BACKGROUND: Thrombopoietin-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. METHODS: A 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. RESULTS: In 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. CONCLUSION: EPAG was preferred over ROMI in the treatment of cITP, largely driven by the reduction in severe bleeding events associated with its use. |
format | Online Article Text |
id | pubmed-6219311 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-62193112018-11-21 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 Clinicoecon Outcomes Res Original Research BACKGROUND: Thrombopoietin-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. METHODS: A 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. RESULTS: In 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. CONCLUSION: EPAG was preferred over ROMI in the treatment of cITP, largely driven by the reduction in severe bleeding events associated with its use. Dove Medical Press 2018-11-01 /pmc/articles/PMC6219311/ /pubmed/30464563 http://dx.doi.org/10.2147/CEOR.S177324 Text en © 2018 Tremblay et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Tremblay, Gabriel Dolph, Mike Bhor, Menaka Said, Qayyim Elliott, Brian Briggs, Andrew Cost-consequence model comparing eltrombopag versus romiplostim for adult patients with chronic immune thrombocytopenia |
title | Cost-consequence model comparing eltrombopag versus romiplostim for adult patients with chronic immune thrombocytopenia |
title_full | Cost-consequence model comparing eltrombopag versus romiplostim for adult patients with chronic immune thrombocytopenia |
title_fullStr | Cost-consequence model comparing eltrombopag versus romiplostim for adult patients with chronic immune thrombocytopenia |
title_full_unstemmed | Cost-consequence model comparing eltrombopag versus romiplostim for adult patients with chronic immune thrombocytopenia |
title_short | Cost-consequence model comparing eltrombopag versus romiplostim for adult patients with chronic immune thrombocytopenia |
title_sort | cost-consequence model comparing eltrombopag versus romiplostim for adult patients with chronic immune thrombocytopenia |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6219311/ https://www.ncbi.nlm.nih.gov/pubmed/30464563 http://dx.doi.org/10.2147/CEOR.S177324 |
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