[Cost minimisation analysis for darbepoetin alpha vs. epoetin alpha in chronic kidney disease patients on haemodialysis].
BACKGROUND
Multiple studies have shown that epoetin alpha (r-HuEpo) and darbepoetin alpha (NESP) are similarly effective and safe for maintaining haemoglobin levels in patients with chronic kidney disease (CKD). Nevertheless, there is some debate over their cost-effectiveness. The purpose of this study is to carry out a cost-minimisation analysis including a comparison of the costs to the hospital arising from treatment with r-HuEpo vs. NESP.


METHODS
Prospective observational study. We included CRF patients on haemodialysis with no iron, vitamin B12 or folate deficiencies, treated with stable doses of IV r-HuEpo. Follow-up was performed over three periods: the first during six months, maintaining prior treatment with r-HuEpo; the second for eight months, after changing to NESP, and the third, during the final eight months, following resuming r-HuEpo treatment. For converting both treatments, the conversion factor established on technical sheet 1:200 was used.


RESULTS
51 patients completed the study and were valid for analysis. Their mean age was 68.3 years, and 18 were women (35.3%). The mean weekly doses at the end of each period were 8,058.8 (SD 3,911.1) IU for the EPO1 period, 39.4 (SD 21.6) microg for NESP and 7,882.4 (SD 4,594.1) IU for EPO2. The weekly costs for each treatment showed significant differences between NESP and r-HuEpo: the cost of NESP was higher.


CONCLUSIONS
In our study, we found that r-HuEpo and NESP were similarly effective in patients with CRF on haemodialysis, but that there was a significant cost increase associated with NESP treatment.
Cuesta Grueso
C
C
Servicio de Farmacia, Hospital Universitario La Fe, Valencia, Spain. grueso_cri@gva.es
Poveda Andrés
J L
JL
Garcia Pellicer
J
J
Romá Sánchez
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000188:drug therapy / Q000191:economics*; D017046:Cost Savings; D003365:Costs and Cost Analysis; D000068256:Darbepoetin alfa; D016527:Drug Costs / Q000706:statistics & numerical data*; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000031:analogs & derivatives* / Q000191:economics* / Q000627:therapeutic use; D005260:Female; D006397:Hematinics / Q000191:economics* / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis; D017721:Hospital Costs / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000191:economics; D006801:Humans; D007501:Iron / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000191:economics* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000191:economics / Q000706:statistics & numerical data; D011446:Prospective Studies; D011994:Recombinant Proteins; D006435:Renal Dialysis; D013030:Spain
D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D000068817:Epoetin Alfa; D007501:Iron