OBJECTIVE

To perfom cost-effectiveness and budget impact analysis (BIA) of thrombopoietin receptor agonists (romiplostim, eltrombopag and avatrombopag) in the treatment of adults with idiopathic thrombocytopenic purpura (ITP) in hospitals of the Moscow region (MR).

MATERIAL AND METHODS

The effectiveness criterion in cost-effectiveness analysis was the patient’s response to therapy. We prepared a model of providing care to adults with ITP. This model included assessment of economic and clinical effectiveness of various treatment strategies, as well as long-term prediction of budget expenditures for MR healthcare system following changes in appropriate practice. The study was conducted from the perspective of regional healthcare system. Therefore, we analyzed only direct medical costs for medications, drug administration, therapy monitoring, «rescue therapy» and treatment of major bleeding.

RESULTS

Cost-effectiveness analysis established the advantage of avatrombopag (981 305.46 rubles) over eltrombopag (1 030 500.81 rubles) and romiplostim (1 918 933.40 rubles) The difference in cost effectiveness of avatrombopag was 1 215.951.77 and 10 726 613.25 rubles, respectively. BIA showed that pharmacotherapy with thrombopoietin receptor agonists will increase total costs by 22.47% by 2025 considering annual increase in the number of patients with ITP and changes in proportions of the analyzed drugs. Treatment strategy for avatrombopag will be economically feasible throughout the entire period.

CONCLUSION

Avatrombopag therapy is a clinically and economically justified strategy for medical care in adults with ITP in the MR.