Current status and cost burden of non-first-line treatment in ITP: A multicenter study based on real-world data in China

Eltrombopag, the first TPO-RA approved for the treatment of ITP, resulted in rapid and sustained increases in platelet counts, significant reductions in bleeding events and concomitant medications, and an acceptable tolerability profile. This study aimed to explore the current status of ITP treatment with eltrombopag as the target drug and the utilization of medical resources from the perspective of hospitals. Data collection was based on two parts: real-world data and expert interviews. Real-world data of outpatients with ITP who received second-line treatment or other treatment from 1 year before to 1 year after eltrombopag admission were collected to analyze the current status of non-first-line treatment in ITP outpatients. Ten specialist physicians were interviewed to collect parameters such as efficacy, safety, and medical cost of ITP treatment regimens. The real-worlddata showed that among non-first-line treatment, market share of second-line treatment was lower than that of other treatment before the admission of eltrombopag, and the market share of second-line treatment was the higher than that of other treatment after the admission of eltrombopag in both adult and pediatric ITP patients. After the admission of eltrombopag, the annual outpatient drug-related treatment costs for adults with ITP increased by ￥13717.05, and the annual outpatient drug-related treatment costs for children with ITP increased by ￥7762.90. The results of expert interviews showed that more patients switched from other treatment to second-line treatment after the admission of eltrombopag in clinical. Eltrombopag demonstrated superior efficacy, safety and higher adherence in second-line treatment. The new oral TPO-RA drugs have improved the treatment options for ITP patients, and more patients accept eltrombopag for non-first-line treatment. After eltrombopag admission, the annual outpatient drug-related treatment costs increased for both adult and pediatric patients. Nevertheless, by reason of advantages of its efficacy, tolerance, medication adherence and other aspects, eltrombopag has become an important drug in the non-first-line treatment of ITP.Additional comprehensive research is needed to verify the results.