Evidence map›Paper›PMID 40276091›Full record

ArticleJournal of market access & health policy2025

The Cost-Effectiveness of Avatrombopag Versus Eltrombopag and Romiplostim in the Treatment of Patients with Immune Thrombocytopenia in the UK.

Nichola Cooper, Sebastian Guterres, Michał Pochopień, Koo Wilson, Sam James, Mondher Toumi, Anna Tytuła, Carly Rich, Daniel Eriksson

Abstract read
In one paragraph

Article in Journal of market access & health policy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Review
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

9 authors.

Nichola CooperFaculty of Medicine, Department of Immunology and Inflammation, Imperial College London, London SW7 2AZ, UK.
Sebastian GuterresSwedish Orphan Biovitrum Ltd., Cambridge CB21 6AD, UK; sebastian.guterres@sobi.com (S.G.); sam.james@sobi.com (S.J.).
Michał PochopieńAssignity, 30-415 Kraków, Poland; mpo@assignity.com.
Koo WilsonSwedish Orphan Biovitrum AB, SE-112 76 Stockholm, Sweden; koo.wilson@sobi.com (K.W.); carly.rich@sobi.com (C.R.); daniel.eriksson@sobi.com (D.E.).
Sam JamesSwedish Orphan Biovitrum Ltd., Cambridge CB21 6AD, UK; sebastian.guterres@sobi.com (S.G.); sam.james@sobi.com (S.J.).
Mondher ToumiDepartment of Public Health, Aix-Marseille University, 13005 Marseille, France; mto@inovintell.com.
Anna TytułaHealth Economics and Outcomes Research Department, Putnam PHMR, 30-701 Kraków, Poland; anna.tytula@putassoc.com.ORCID https://orcid.org/0009-0004-8827-1469
Carly RichSwedish Orphan Biovitrum AB, SE-112 76 Stockholm, Sweden; koo.wilson@sobi.com (K.W.); carly.rich@sobi.com (C.R.); daniel.eriksson@sobi.com (D.E.).
Daniel ErikssonSwedish Orphan Biovitrum AB, SE-112 76 Stockholm, Sweden; koo.wilson@sobi.com (K.W.); carly.rich@sobi.com (C.R.); daniel.eriksson@sobi.com (D.E.).ORCID https://orcid.org/0000-0001-7699-242X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThrombopoietin receptor agonists-romiplostim, eltrombopag and avatrombopag-are commonly used as second-line treatments for immune thrombocytopenia (ITP).

methodsA Markov model was developed to estimate the cost effectiveness of the three TPO-RAs in adults with insufficient response to previous treatment from the perspective of the UK National Health Service (NHS). The model considered the effects of bleeding events, concomitant ITP medications, rescue therapies and treatment related adverse events over a lifetime horizon. Model inputs for effectiveness were based on a network meta-analysis and other published literature on ITP management. Other model inputs included costs (e.g., drug acquisition and administration) and healthcare resource utilisation.

resultsAvatrombopag was associated with higher quality-adjusted life-years (QALYs) (10.979) than romiplostim (10.628) and eltrombopag (10.085), producing incremental QALYs of -0.351 and -0.894, respectively. Avatrombopag was associated with lower total costs (GBP £319,334) compared with romiplostim (GBP 406,361 [cost saving of GBP 87,027]) and higher total costs compared with eltrombopag (GBP 313,987 [incremental cost of GBP 5347]). Avatrombopag therefore dominated romiplostim (more effective and less expensive) and was cost-effective versus eltrombopag (incremental cost-effectiveness ratio of GBP 5982 per QALY).

conclusionsAvatrombopag is a cost-effective treatment compared with romiplostim and eltrombopag for the second-line treatment of adults with ITP from the perspective of the UK NHS.

Indexed as

avatrombopagcost-effectivenesseltrombopagimmune thrombocytopeniaincremental cost-effectiveness ratioromiplostimthrombopoietin receptor agonists

Identifiers

PMID40276091
PMCPMC12015888

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Registered trials

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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.