Pharmacoeconomic study of the use of thrombopoietin receptor agonists in adult patients with chronic idiopathic thrombocytopenic purpura in Russian federation

Aim: to perform the analysis of different agonists of thrombopoietin receptors - romiplostim and eltrombopag in adult patients with chronic idiopathic thrombocytopenic purpura (ITP) in Russia. Methodology: There has been developed model of medical care patients with ITP based on the research hypothesis suggesting the possible low level of compliance in certain categories of patients for long-term independent daily intake of the drug eltrombopag (50 mg tablets). To evaluate the clinical practice for ITP patients in Russia the interview of experts was performed. Direct medical costs were calculated per 1 patient. Results: Total costs of the treatment per ITP patient within the 1 year period were 3,895,692 rubles with romiplostim and 1,788,537 rubles with eltrombopag. However, taking into account a possible low level of compliance of certain categories of patients in clinical practice in Russia and therefore the probable decline of the efficacy of therapy the cost-effectiveness ratio for romiplostim amounted to 4,693,605 rubles/1 case of the effective treatment if compared with 6,387,631 rubles/1 case of the effective treatment for eltrombopag. The difference amounted to 1,694,026 rubles in favor of the drug romiplostim. Conclusion: The use of romiptostim in the treatment of adult ITP patients was both effective and economically justified as treatment option in real practice in patients with low compliance in Russia.