Currently Viewing:
The American Journal of Managed Care Special Issue: Pharmacy Benefits
A Gray Area for Reimbursement: Medical Foods for Non–Inborn Errors of Metabolism
Leslie Wilson, PhD; Tracy Kuo Lin, MSc, PhD; Anna Oh, RN, MPH; and Vicky Cao, PharmD
Disease-Modifying Antirheumatic Drug Initiation Among Patients Newly Diagnosed With Rheumatoid Arthritis
Machaon Bonafede, PhD, MPH; Barbara H. Johnson, MBA; Neel Shah, PhD, BPharm; David J. Harrison, PhD; Derek Tang, PhD, BSPharm; and Bradley S. Stolshek, PharmD
Currently Reading
Cost Per Response Analysis of Strategies for Chronic Immune Thrombocytopenia
Kelly Fust, MS; Anju Parthan, PhD; Xiaoyan Li, PhD; Anjali Sharma, MD; Xinke Zhang, MS; Marco Campioni, PhD; Junji Lin, PhD, MS; Xuena Wang, PhD; Richard Zur, PhD; Karynsa Cetin, MPH; Melissa Eisen, MD; and David Chandler, PhD
5-ASA to Sulfasalazine Drug Switch Program in Patients With Ulcerative Colitis
Jason R. Goldsmith, MD, PhD; Akbar K. Waljee, MD; Tom George, PharmD; Alexandra Brown, BS; Hae Mi Choe, PharmD; Mohamed Noureldin, MBBS; Steven J. Bernstein, MD, MPH; and Peter D.R. Higgins, MD, PhD
Direct Oral Anticoagulant Prescription Trends, Switching Patterns, and Adherence in Texas Medicaid
Shui Ling Wong, MS; Landon Z. Marshall, PharmD; and Kenneth A. Lawson, PhD
Two-Year Adherence and Costs for Biologic Therapy for Rheumatoid Arthritis
Bradley S. Stolshek, PharmD; Sally Wade, MPH; Alex Mutebi, PhD, MSc; Ajita P. De, MA, MPhil, MS; Rolin L. Wade, MS; and Jason Yeaw, MPH
Cost of Biologic Treatment Persistence or Switching in Rheumatoid Arthritis
Tao Gu, PhD; Alex Mutebi, PhD; Bradley S. Stolshek, PharmD; and Hiangkiat Tan, MS, BSPharm
Impact of Medical and/or Pharmacy Reimbursement on Adult Vaccination Rates
Gaurav Deshpande, PhD, MS; Jay Visaria, PhD, MPH; Joseph Singer, MD; and Kelly D. Johnson, PhD, MPH
Treatment Patterns Among Adults With ADHD Receiving Long-Acting Therapy
Zhou Zhou, MS; Zheng-Yi Zhou, PhD; Sneha S. Kellar, MPH; Vanja Sikirica, PharmD, MPH; Jipan Xie, MD, PhD; and Regina Grebla, PhD
Modeling the Impacts of Restrictive Formularies on Patients With HIV
James Baumgardner, PhD; Caroline Huber, MPH; Mina Kabiri, PhD; Lara Yoon, MPH; Jacki Chou, MPP, MPL; and John Romley, PhD

Cost Per Response Analysis of Strategies for Chronic Immune Thrombocytopenia

Kelly Fust, MS; Anju Parthan, PhD; Xiaoyan Li, PhD; Anjali Sharma, MD; Xinke Zhang, MS; Marco Campioni, PhD; Junji Lin, PhD, MS; Xuena Wang, PhD; Richard Zur, PhD; Karynsa Cetin, MPH; Melissa Eisen, MD; and David Chandler, PhD
This decision tree model estimates the cost per response and incremental cost per additional responder for romiplostim, eltrombopag, and “watch and rescue” for immune thrombocytopenia.
ABSTRACT

Objectives: This analysis estimated the cost per response and the incremental cost per additional responder of romplostim, eltrombopag, and the “watch-and-rescue” (monitoring until rescue therapies are required) strategy in adults with chronic immune thrombocytopenia (ITP).

Study Design: The decision tree is designed to estimate the total cost per response for romiplostim, eltrombopag, and watch and rescue over a 24-week time horizon; cost-effectiveness was evaluated in terms of incremental cost per additional responder.

Methods: Model inputs including response rates, bleeding-related episode (BRE) rates, and costs were estimated from registrational trial data, an independent Bayesian indirect comparison, database analyses, and peer-reviewed publications. Costs were applied to the proportions of patients with treatment response and nonresponse (based on platelet count). The total cost per response and the incremental cost per additional responder for each treatment were calculated. Sensitivity analyses and alternative analyses were performed.

Results: With higher total costs and greater treatment efficacy, romiplostim and eltrombopag had a lower 24-week cost per response and a lower average number of BREs than watch and rescue. Eltrombopag was weakly dominated by romiplostim. The incremental cost-effectiveness ratio of romiplostim versus watch and rescue was $46,000 per additional responder. The model results are most sensitive to response rates of romiplostim and watch and rescue and the BRE rate for splenectomized nonresponders. Alternative analyses results were similar to the base case.

Conclusions: In adults with chronic ITP, romiplostim represents an efficient way to achieve response, with lower costs per response than eltrombopag; both romiplostim and eltrombopag had lower costs per response than watch and rescue.

Am J Manag Care. 2018;24(Spec Issue No. 8):SP294-SP302

Become a Member to see the rest of this article and get access to all of our articles and resources. Membership is Free!

 
Copyright AJMC 2006-2018 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up
×

Sign In

Not a member? Sign up now!