摘要:
Introduction : Novel non-surgical options for treatment of chronic immune thrombocytopenic purpura (ITP) are emerging. These include rituximab, an anti-CD20 monoclonal antibody, and romiplostim, a soon to be approved thrombopoeitic receptor agonist. However, long-term clinical data with these agents have not been reported previously and the cost of romiplostim treatment has not been announced. Herein, we report a "break-even" cost-effectiveness analysis, based on 2.5 years clinical outcome data for both agents, which yields a suggested market cost for romiplostim that would result in equivalent cost-effectiveness profiles for the two agents when administered as treatment for chronic ITP.
Methods: Effectiveness data were based on 2.5-years results from studies of chronic ITP patients treated with rituximab or romiplostim. We calculated the total costs of treating a cohort of chronic ITP patients with ritiuxan with splenectomy salvage (estimated cost of $8,100) as the therapeutic choice for treatment failures. We subsequently calculated a break-even price for romiplostin with splenectomy salvage that would result in a total cost of treating an ITP cohort equivalent to the costs of treating the rituximab/splenectomy cohort.
Results: At 2.5 years follow-up, a cohort of 100 chronic ITP patients initially treated with rituximab is associated with 40 therapeutic failures going on to splenectomy annually. Total treatment costs for this cohort is estimated at $2.2 million. At 2.5 years follow-up, a cohort of 100 chronic ITP patients initially treated with romiplostim is associated with 10 splenectomy failures per year. Total 2.5 year treatment costs for this cohort