OBJECTIVES:  Recombinant Human Thrombopoietin (rhTPO) was recommended to emergency treatment in primary immune thrombocytopenia (ITP) patients in China. The application of rhTPO could potentially reduce the usage of platelet transfusion and intravenous immunoglobulin for emergency treatment of ITP patients. The study purpose is to evaluate the hypothesis in clinical practice. METHODS:   An expert questionnaire was designed to collect relevant clinical information of emergency treatment in ITP patients. 53 hematologists completed the questionnaire who were selected from Beijing, Shanghai, Guangzhou, Jinan, Chengdu and Wuhan in China. The treatment cost of with and without rhTPO for emergency treatment in ITP patients was compared. RESULTS:

The survey results indicate that , the rate of platelet transfusion is 50% and 85% for with rhTPO and without rhTPO respectively. The intravenous immunoglobulin in the emergency treatment of ITP patients was 30% and 50% for with rhTPO and without rhTPO respectively. And the average amount of platelet and intravenous immunoglobulin used for an ITP patient was 1.5 unit (200 ml/unit) and 5 days (400 mg/kg per day) for both groups. The treatment cost of one unit platelet transfusion conducted in other previously study was RMB 5,114. The daily treatment cost of intravenous immunoglobulin was RMB 5,000. Thus, in with rhTPO arm, the cost of platelet transfusion and intravenous immunoglobulin was RMB 3,835.5 and RMB 7,500. In without arm, the cost was RMB 6,520.35 and RMB 12,500 respectively. With rhTPO price is RMB 1,102, 7 days per an ITP patient emergency treatment. The drug price of rhTPO is RMB 7,714. So the total cost of the two arms was RMB 19,049.5 (with rhTPO) and RMB 19,020.4 (without rhTPO). The gap is only RMB 29.2. CONCLUSIONS:

The use of rhTPO for emergency treatment in ITP patients could reduce the rate of usage of platelet transfusion and intravenous immunoglobulin without significantly increase medical cost.