Launch of Generic Eltrombopag Expands Access for Patients With Thrombocytopenia, Aplastic Anemia

Camber Pharmaceuticals is launching generic eltrombopag, the first AB-rated generic alternative to Promacta (Novartis). This development holds significant implications for both oncology and community pharmacists, promising to broaden access to a crucial medication for patients with thrombocytopenia and aplastic anemia.¹

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Thrombocytopenia, characterized by abnormally low platelet counts (<150,000µL), can lead to an increased risk of bleeding. The etiology of thrombocytopenia is diverse, caused by an immune disorder in chronic immune thrombocytopenia (ITP), or by liver disease and splenic sequestration in chronic hepatitis C infection. Severe aplastic anemia is a rare and serious bone marrow failure disorder in which the bone marrow does not produce enough new blood cells, including platelets, leading to life-threatening complications.^2,3

Eltrombopag is a thrombopoietin receptor agonist that works by stimulating the production of platelets in the bone marrow. Its approval has significantly improved the management of thrombocytopenia in these patient populations, reducing the need for platelet transfusions and decreasing the risk of bleeding events.⁴ Prior to the launch of this generic, however, Promacta carried a significant cost burden, potentially limiting its accessibility for some patients.

The introduction of generic eltrombopag is pivotal for several reasons. Generics play a crucial role in reducing health care costs, making effective treatments more affordable and accessible to a wider patient population. This increased affordability can improve adherence to therapy and ultimately lead to better patient outcomes. For those with chronic conditions such as ITP or those undergoing long-term treatment for aplastic anemia, the cost savings associated with generic medications can be substantial.

Implications for Oncology Pharmacists

Oncology pharmacists frequently encounter thrombocytopenia as a result of myelosuppressive chemotherapy or as an underlying condition in hematologic malignancies, such as myelodysplastic syndromes or leukemia. Although eltrombopag’s primary FDA indications are for ITP and aplastic anemia, its off-label use in chemotherapy-induced thrombocytopenia and other oncologic settings has been explored.^5,6

The availability of a lower-cost generic option may facilitate broader consideration of eltrombopag in situations where platelet production needs to be stimulated, always within the context of evidence-based practice and established guidelines. Oncology pharmacists will need to be knowledgeable about the specific indications, contraindications, and potential drug–drug interactions of generic eltrombopag, just as they are with the branded product. They will also play a key role in educating prescribers and patients about the availability and potential cost savings associated with the generic formulation.

Implications for Community Pharmacists

Community pharmacists are often the first point of contact for patients filling their prescriptions and managing chronic conditions. As generic eltrombopag becomes more widely prescribed, community pharmacists will need to be prepared to dispense it accurately and provide comprehensive counseling to patients. This includes educating patients on proper storage, administration, potential adverse effects, and the importance of adherence.

Furthermore, pharmacists will also play a vital role in managing insurance coverage and navigating potential prior authorization processes that may still be in place for the generic formulation. Camber is offering a copayment program in which eligible patients may pay as little as $0 out of pocket.¹ Collaboration with providers and specialty pharmacies will be crucial to ensure seamless access to this important medication for patients in the community setting.

“For years, many patients have struggled to afford this life-saving therapy,” said Kon Ostaficiuk, president of Camber Pharmaceuticals, in a news release. “We are excited to offer this important medication with a copay assistance program.”¹

Conclusion

The launch of generic eltrombopag represents a significant step forward in improving access to a vital therapy for patients with various forms of thrombocytopenia and aplastic anemia. Both oncology and community pharmacists must stay informed about this development to optimize patient care, reduce health care costs, and ensure the safe and effective use of this medication across diverse clinical settings. The availability of a more affordable generic option has the potential to positively impact the lives of many individuals living with these conditions.

REFERENCES

1. Camber Launches Eltrombopag PFOS & Tablets. News release. Camber Pharmaceuticals. May 13, 2025. Accessed May 6, 2025 [Email].

2. Thrombocytopenia. National Heart, Lung, and Blood Institute. Updated March 24, 2022. Accessed May 6, 2025. https://www.nhlbi.nih.gov/health/thrombocytopenia#:~:text=What%20is%20thrombocytopenia%3F-,What%20is%20it%3F,is%20called%20a%20blood%20clot

3. Aplastic Anemia. National Heart, Lung, and Blood Institute. Updated March 24, 2022. Accessed May 6, 2025. https://www.nhlbi.nih.gov/health/anemia/aplastic-anemia#:~:text=Aplastic%20anemia%20is%20a%20rare,way%20to%20prevent%20aplastic%20anemia

4. Eltrombopag (oral route). Mayo Clinic. Updated May 1, 2025. Accessed May 6, 2025. https://www.mayoclinic.org/drugs-supplements/eltrombopag-oral-route/description/drg-20072443

5. Winer ES, Safran H, Karaszewska B, et al. Eltrombopag with gemcitabine-based chemotherapy in patients with advanced solid tumors: a randomized phase I study. Cancer Med. 2014;4(1):16-26.

6. Iuliano F, Iuliano E, Perricelli A, et al. Low doses of eltrombopag are safe and effective in the prophylaxis of the chemotherapy-induced thrombocytopenia (CIT). Blood. 2016;128(22):4926. doi:10.1182/blood.V128.22.4926.4926