title: The economic impact of pre-dialysis epoetin alpha on health care and work loss costs in chronic kidney disease: an employer's perspective.
abstract: The objective of the study was to quantify the direct and indirect incremental costs of epoetin alpha (EPO) therapy for anemia in pre-dialysis chronic kidney disease (CKD). Using employer claims data from January 1998 to January 2005, direct (medical and pharmacy) and indirect (sick leave and disability) costs were compared between CKD-anemic patients treated with EPO before dialysis (n = 199) and those not treated with an erythropoiesis-stimulating therapy (EST) (n = 196). Among the results, incremental direct and indirect cost savings for EPO-treated patients were $1443 and $328 per member per month (PMPM) (p < 0.001), respectively, compared to non-EST-treated patients with anemia. After multivariate adjustments, direct and indirect costs remained significantly lower by $852 and $308 PMPM (p < 0.001), respectively, for the EPO-treated group. Direct costs during the first 6 months of dialysis also were significantly lower for the EPO-treated group (who received EPO before dialysis), by $1515 PMPM (p = 0.0267, in multivariate regression). In conclusion, anemic CKD patients treated with EPO before dialysis had significantly lower direct and indirect costs compared to non-EST-treated patients.
authors.affiliation: Analysis Group, Boston, Massachusetts 02199, USA.
authors.forename: Erick
authors.initials: E
authors.lastname: Moyneur
authors.forename: Brahim K
authors.initials: BK
authors.lastname: Bookhart
authors.forename: Samir H
authors.initials: SH
authors.lastname: Mody
authors.forename: Andrée-Anne
authors.initials: AA
authors.lastname: Fournier
authors.forename: David
authors.initials: D
authors.lastname: Mallett
authors.forename: Mei Sheng
authors.initials: MS
authors.lastname: Duh
mesh_terms: D000368:Aged; D000740:Anemia / Q000191:economics* / Q000517:prevention & control / Q000534:rehabilitation; D003365:Costs and Cost Analysis; D004185:Disability Evaluation; D004921:Erythropoietin / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007345:Insurance Claim Review; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011994:Recombinant Proteins; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin