title: Hemoglobin level at initiation of darbepoetin alfa: impact on need for transfusion and associated costs in chemotherapy-induced anemia treatment in Europe.
abstract: OBJECTIVE
  Erythropoiesis-stimulating agents can reduce red blood cell transfusion rates in patients developing anemia while receiving chemotherapy. We investigated potential cost savings from reduced transfusion rates in patients starting darbepoetin alfa (DA) at higher versus lower hemoglobin (Hb) levels.
  
  
  METHODS
  Two systematic literature reviews were performed: transfusion outcomes in patients receiving DA stratified by baseline Hb level and costs of transfusion in Europe. Potential cost savings were calculated by multiplying the difference in transfusion rates between Hb levels by the midpoint of transfusion costs.
  
  
  RESULTS
  Despite differences in baseline characteristics, treatment duration and analysis technique, the clinical studies (n = 8) showed that fewer transfusions were required when DA was initiated at higher versus lower Hb levels. The economic studies (n = 9) showed that 1 unit of transfusion ranged from <euro>130 to <euro>537 (2010-adjusted values). Cost savings from initiating DA at higher versus lower Hb levels were <euro>503-2,226 (2 units transfused) and <euro>880-3,895 (3.5 units) per ten patients.
  
  
  CONCLUSIONS
  Transfusion incidence increases with DA initiation at lower Hb levels. Potential cost savings depend on the number of units transfused and cost items included. DA initiation according to guidelines can reduce transfusions and potentially reduce transfusion-associated costs.
authors: Welsh School of Pharmacy, Cardiff University, Redwood Building, King Edward VII Avenue, Cardiff, CF10 3NB, UK.
authors: Melike
authors: M
authors: Deger
authors: Wolfgang
authors: W
authors: Eisterer
authors: Lucie
authors: L
authors: Kutikova
authors: Sam
authors: S
authors: Salek
mesh_terms: D000740:Anemia / Q000139:chemically induced* / Q000188:drug therapy / Q000191:economics; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D017046:Cost Savings; D000068256:Darbepoetin alfa; D017707:Erythrocyte Transfusion / Q000191:economics* / Q000706:statistics & numerical data; D004921:Erythropoietin / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D006397:Hematinics / Q000191:economics / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis / Q000187:drug effects*; D006801:Humans; D039781:PubMed
chemical_list: D000970:Antineoplastic Agents; D006397:Hematinics; D006454:Hemoglobins; D004921:Erythropoietin; D000068256:Darbepoetin alfa