OBJECTIVES: Immune thrombocytopenia (ITP) is an immunologic blood disorder characterised by low platelet counts and bleeding. The management of ITP aimed at minimising bleeding events. Eltrombopag is an oral thrombopoietin receptor agonist indicated as second line treatment of chronic ITP in adults. This economic study estimated the direct costs of ITP management with eltrombopag in the French setting. METHODS: A phase III clinical trial (RAISE) compared the response to once daily eltrombopag versus placebo in adult patients with chronic ITP during a 6-month period. Use of medical resources was assessed from the RAISE data regarding eltrombopag dosage, treatment duration, bleeding-related events (BREs grade 2+), rescue therapy (IVIG, oral steroids), concomitant medications and hospitalisations. The economic analysis was restricted to direct costs (2011 values) measured in the perspective of the French Sickness Fund (full coverage for ITP). RESULTS: For 6 months of treatment, total cost per patient receiving eltrombopag (mean dose: 55.2mg) was estimated at 15,318 € with 88.9 % of the costs induced by the main drug treatment. Monitoring costs related to eltrombopag (blood tests and visits) were estimated at 403 € (2.6%). At least, concomitant drugs, BREs and rescue therapy were respectively accounting for 623 € (4.1%), 730 € (4.8%) and 344 € (2.2%). These results seem consistent with other French economic estimations concerning patients treated with IVIG (13,291 €/6 months) or patient treated with romiplostim (3µg/Kg, 17,486 €/6 months). CONCLUSIONS: With the data from the RAISE clinical trial, the direct cost for a patient treated with eltrombopag during a 6 months period was estimated at 15,318 €. Estimation of direct costs may be envisaged in an exploratory manner when Phase III clinical trials are close to real practice management and has to be confirmed by collected resource utilization in observational studies.