Evidence map›Paper›PMID 37145291›Full record

SynthesisPharmacoEconomics2023

Cost-Effectiveness of Thrombopoietin Mimetics in Patients with Thrombocytopenia: A Systematic Review.

Hans Van Remoortel, Hans Scheers, Bert Avau, Jørgen Georgsen, Susan Nahirniak, Nadine Shehata, Simon J Stanworth, Emmy De Buck, Veerle Compernolle, Philippe Vandekerckhove

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in PharmacoEconomics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Hans Van RemoortelCentre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium. hans.vanremoortel@cebap.org.ORCID 0000-0003-1942-1799
Hans ScheersCentre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium.
Bert AvauCentre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium.
Jørgen GeorgsenDepartment of Clinical Immunology, South Danish Transfusion Service and Tissue Center, Odense University Hospital, Odense, Denmark.
Susan NahirniakFaculty of Medicine, University of Alberta, Edmonton, Canada.
Nadine ShehataDepartments of Medicine, Laboratory Medicine and Pathobiology, Institute of Health Policy Management and Evaluation, University of Toronto, Mount Sinai Hospital, Toronto, Canada.
Simon J StanworthTransfusion Medicine, NHS Blood and Transplant, Oxford, UK.
Emmy De BuckCentre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium.
Veerle CompernolleBlood Services, Belgian Red Cross, Mechelen, Belgium.
Philippe VandekerckhoveDepartment of Public Health and Primary Care, Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThrombopoietin (TPO) mimetics are a potential alternative to platelet transfusion to minimize blood loss in patients with thrombocytopenia. This systematic review aimed to evaluate the cost-effectiveness of TPO mimetics, compared with not using TPO mimetics, in adult patients with thrombocytopenia.

methodsEight databases and registries were searched for full economic evaluations (EEs) and randomized controlled trials (RCTs). Incremental cost-effectiveness ratios (ICERs) were synthesized as cost per quality-adjusted life year gained (QALY) or as cost per health outcome (e.g. bleeding event avoided). Included studies were critically appraised using the Philips reporting checklist.

resultsEighteen evaluations from nine different countries were included, evaluating the cost-effectiveness of TPO mimetics compared with no TPO, watch-and-rescue therapy, the standard of care, rituximab, splenectomy or platelet transfusion. ICERs varied from a dominant strategy (i.e. cost-saving and more effective), to an incremental cost per QALY/health outcome of EUR 25,000-50,000, EUR 75,000-750,000 and EUR > 1 million, to a dominated strategy (cost-increasing and less effective). Few evaluations (n = 2, 10%) addressed the four principal types of uncertainty (methodological, structural, heterogeneity and parameter). Parameter uncertainty was most frequently reported (80%), followed by heterogeneity (45%), structural uncertainty (43%) and methodological uncertainty (28%).

conclusionsCost-effectiveness of TPO mimetics in adult patients with thrombocytopenia ranged from a dominant strategy to a significant incremental cost per QALY/health outcome or a strategy that is clinically inferior and has increased costs. Future validation and tackling the uncertainty of these models with country-specific cost data and up-to-date efficacy and safety data are needed to increase the generalizability.

Indexed as

ThrombocytopeniaThrombopoietinAdultCost-Benefit AnalysisHemorrhageHumansQuality-Adjusted Life YearsThrombopoietin

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.