Anemia in cancer and critical care patients: pharmacoeconomic considerations.
OBJECTIVE
The elements and limitations of pharmacoeconomic models, types of analytic methods used in pharmacoeconomic evaluations, outcomes used in studies of anemia treatments, and comparative efficacy and cost-effectiveness of the two available erythropoietic therapies in the treatment of anemia in cancer and critical care patients are discussed.


CONCLUSIONS
Clinical, humanistic, and economic outcomes should be taken into consideration in pharmacoeconomic models. The validity of such models may be compromised by a lack of outcome data, unreasonable assumptions, the heterogeneity of the patient population, patient selection bias in comparative studies, and inconsistent use of instruments to measure outcomes. The degree of anemia in patients with cancer correlates with health-related quality of life (QOL). Erythropoietic therapy increases hemoglobin concentrations and QOL, reduces the need for blood transfusions, and is cost-effective for treating anemia in cancer and critical care patients. Epoetin alfa may provide a more rapid hemoglobin response and improvement in QOL at a lower cost than darbepoetin alfa. Front loading with weekly doses of either erythropoietic agent followed by a three-week-long dosing interval for maintenance treatment may be used to quickly correct anemia, improve convenience, and reduce costs.


CONCLUSIONS
Erythropoietic therapy for the treatment of anemia in cancer and critical care patients is cost-effective.
Reeder
C Eugene
CE
College of Pharmacy, University of South Carolina, Columbia, SC 28208, USA. reeder@cop.sc.edu
D000740:Anemia / Q000150:complications / Q000188:drug therapy* / Q000191:economics; D003362:Cost-Benefit Analysis; D003422:Critical Care; D016638:Critical Illness; D000068256:Darbepoetin alfa; D017850:Economics, Pharmaceutical; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D011788:Quality of Life; D011994:Recombinant Proteins
D011994:Recombinant Proteins; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D000068817:Epoetin Alfa