Abstract

PARRONDO, J. et al. Economic evaluation of Thrombopoietin Receptor Agonists in the treatment of chronic Primary Immune Thrombocytopenia. Farm Hosp. [online]. 2013, vol.37, n.3, pp.182-191. ISSN 2171-8695.  https://dx.doi.org/10.7399/FH.2013.37.3.526.

Purpose: To develop a tool to assist the decision-making for selection of Thrombopoyetin Receptor Agonists of adult patients with chronic immune primary thrombocytopenia (PTI). Methods: Stochastic cost-effectiveness analysis with a 6-Health-States Markov model: stable, bleeding type 2, 3 or 4, post-type 4 bleeding and death. Each simulation analyzes a randomly generated scenario that describes patients characteristics, results measured in quality adjusted life years (QALYs) and costs (in €2011). Distributions were obtained from the Spanish data of the European health survey of 2009, the INE estimate of population for 2011 and the 6-months clinical studies for Eltrombopag and Romiplostim. Utility values were obtained from the literature and the costs from Spanish official rates lists. A set of 10.000 random scenarios were generated and the patients evolution of each scenario was simulated during a time horizon of five years (in 2-weeks cycles). National Health System Perspective was used and the annual discount rate was set at 3%. Results: Eltrombopag showed more effectiveness in 9.983 scenarios and there was no difference in 17. In 7.048 scenarios the alternative Eltombopag was dominant. It was cost-effective in another 19 (threshold 30,000 € /AVAC). Conclusions: Eltrombopag was the most cost-effective alternative in 70,67% of the simulated scenarios and its use could produce lower costs to the NHS.

Keywords : ITP; Eltrombopag; Thrombopoyetin Receptor Agonists; Economic Evaluation.

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