Objective  To evaluate the cost-effectiveness of recombinant human throm-bopoietin (rhTPO) and interleukin-11 (IL-11) for the treatment of cancer therapy-induced thrombocytopenia (CTIT) and to provide a cost basis for the clinical application of these drugs.

Methods  Retrospective data of non-myeloid malignant tumor patients with CTIT treated in the Bozhou People’s Hospital from January 2023 to July 2025 were collected, and the patients were divided into the rhTPO group and the IL-11 group according to different treatment regimens. Propensity score matching (PSM) was used to adjust the baseline indicators with significant differences. Using the increase in platelet count as the health output, a decision tree model was used to calculate the incremental cost-effectiveness ratio (ICER) for two drugs of CTIT treatment. Sensitivity analysis was conducted to validate the robustness of the results and the economic viability under different willingness-to-pay (WTP) thresholds.

Results  A total of 426 patients were collected, including 252 in the rhTPO group and 174 in the IL-11 group; 157 patients were included in each group after PSM. The effective rate was 90.45% in the rhTPO group and 82.17% in the IL-11 group, with a statistically significant difference between the two groups (P<0.05). The basic results show that the ICER of rhTPO compared to IL-11 was 90,067.75 yuan per effective case. Sensitivity analysis showed that the results of basic analysis were robust, while single factor sensitivity analysis showed that the effectiveness of the rhTPO group had the greatest impact on the robustness of the model results. The results of probability sensitivity analysis show that when the WTP threshold is 89,000 yuan, the economic viability of the two is equal. Based on the WTP threshold set in this paper, the probability that the rhTPO group was managed in a cost-effective manner was 95.7%.

Conclusion  When the WTP threshold is greater than 89,000 yuan, rhTPO is more economical than IL-11 in treating CTIT. In clinical practice, rhTPO with higher efficacy and lower adverse reaction rate can be recommended as the first-line treatment.

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