A systematic review and economic evaluation of epoetin alfa, epoetin beta and darbepoetin alfa in anaemia associated with cancer, especially that attributable to cancer treatment

Abstract

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The cost-effectiveness of treatment with erythropoietin compared to red blood cell transfusions for patients with chemotherapy induced anaemia: A Markov model

“…Treatment strategies where patients are given EPO and complementary RBCT were compared to different strategies where patients are treated with RBCT alone. The model was based on a model commissioned by NICE [11], henceforth denoted the NICE model, and adjusted to reflect Swedish treatment practice. Data informing the model's parameters were taken from the NICE model, except data regarding patient characteristics and response rates associated with EPO and RBCT treatment which was obtained from a Swedish observational study [12].…”

“…If the patient does not respond to EPO treatment during the first treatment cycle, the dose is maintained at the initial level during the second cycle and in case the patient still does not respond during the second cycle, EPO treatment is terminated. Once the patient has responded, response is assumed to continue [14], and EPO treatment is maintained until the Hb-level has reached a target Hb-level. Costs and effects associated with two different target levels are modelled, i.e.…”

“…Data concerning the relation between Hb-concentrations and quality of life was taken from the NICE model, where the results of a systematic review of EPO for treatment of anaemia associated with cancer were used to estimate QALYs associated with changes in Hb-concentrations [14] (see Table I). The utility levels in the table are measured using the Time-Trade-Off (TTO) method.…”

Activities of erythropoietin on tumors: An immunological perspective

“…The recent interest of EPO as a treatment for other disease conditions originates from the identification of its neuroprotective activities. Earlier studies showed that EPO has a subjective quality-of-life benefit in cancer patients (reviewed in [1]), but only recently systemicallyadministered EPO was shown to pass the blood-brain barrier and protect from neuronal death in traumatic and ischemic brain injury [2]. Since then, EPO has been shown to be tissue-protective in animal models of various diseases including multiple sclerosis, spinal cord injury, peripheral neuropathies, and renal and cardiac ischemia (reviewed in [2]).…”

“…In this regard, the antitumor effect in MM might be due to the favorable absence of EPOR on MM cells [10]. While analysis of the existing clinical trials have not yet fully clarified this issue [1], a cautionary approach seems advisable.…”