Assessment of the economic value of epoetin use in anemic cancer patients.
Anemia is a common occurrence in cancer patients, as a consequence of the disease process and treatment. Until recently, the only treatment available for anemia was red blood cell transfusions, but this was withheld until the development of severe anemia because of the risks associated with transfusion. Since the mid 1990s, recombinant human erythropoietin (rHuEPO) has been available as an alternative treatment option, which could be used to treat mild-to-moderate anemia and to prevent severe anemia. Many clinicians currently believe that anemia should be treated vigorously, because this is thought to improve patient quality of life, partly because of new research indicating that anemia may be an independent risk-factor for survival. Possible mechanisms behind such an association are not yet completely elucidated, but some clinicians argue that rHuEPO is an ideal drug for the treatment of mild and moderate anemia, as it is perceived to be without serious negative side effects. However, rHuEPO is an expensive drug and the evidence on how to use it optimally, is still highly incomplete.
Neymark
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EORTC Health Economics Unit, Brussels, Belgium. nne@eortc.be