Doptelet demonstrates cost-effectiveness for the treatment of thrombocytopenia in patients with chronic liver disease.- Dova Pharma/Sobi

Dova Pharmaceuticals, a wholly owned subsidiary of Swedish Orphan Biovitrum AB (publ) (Sobi), presented data on the cost effectiveness of Doptelet (avatrombopag) for the treatment of thrombocytopenia in patients with chronic liver diseases (CLD) who are scheduled to undergo a procedure at the 61st Annual Meeting of the American Society of Hematology (ASH) taking place in Orlando, 7-10 December. Patients with CLD often have severe thrombocytopenia (platelet counts less than 50,000/�L) that can complicate the invasive diagnostic and therapeutic procedures these patients require as part of their clinical management, due to the increased bleeding risk.

Doptelet is a thrombopoietin receptor agonist (TPO-RA) that is approved for the treatment of thrombocytopenia in adult patients with CLD as an alternative to platelet transfusions for patients undergoing a procedure. The aim of the study was to evaluate the relative cost-effectiveness of avatrombopag compared with platelet transfusion or treatment with lusutrombopag, another TPO-RA also approved for the treatment of thrombocytopenia in adult patients with CLD.

�The results showed that the use of avatrombopag is a practical strategy compared with the cost of both platelet transfusion and lusutrombopag, as it saves costs and reduces the need for prophylactic platelet transfusions and is as such a cost-effective treatment for thrombocytopenia in patients with CLD�, says Kavita Aggarwal, Vice President Medical Affairs at Dova Pharmaceuticals.

Method and results A decision-tree model was developed from a US payer perspective to capture the clinical events observed in registration trials, and to project potential longer-term complications resulting from a major bleed or thromboembolic event in the scenario analyses. Treatment costs were taken from publicly available data sources; avatrombopag and lusutrombopag estimates were calculated from the US prescribing information and phase III study data. In the overall population, avatrombopag reduced the need for platelet transfusions and produced cost-savings per person compared to intended platelet transfusion (80 per cent fewer prophylactic platelet transfusions), resulting in a relative cost savings of $ 4,250. The cost for lusutrombopag (15 per cent more platelet transfusions) relative to avatrombopag was $5,819 higher than the cost of avatrombopag. The one-way and probabilistic sensitivity analyses showed that the use of avatrombopag remained cost-saving over a wide range of changes, with incremental cost-effectiveness including decreased costs and importantly, avoiding prophylactic platelet transfusions.