Cost-effectiveness of continuous erythropoietin receptor activator in anemia

Abstract

BackgroundErythropoiesis-stimulating agents (ESAs) are the mainstay of anemia therapy. Continuous erythropoietin receptor activator (CERA) is a highly effective, long-acting ESA developed for once-monthly dosing. A multitude of clinical studies has evaluated the safety and efficiency of this treatment option for patients with renal anemia. In times of permanent financial pressure on health care systems, the cost-effectiveness of CERA should be of particular importance for payers and clinicians.ObjectiveTo critically analyze, from the nephrologists’ point of view, the published literature focusing on the cost-effectiveness of CERA for anemia treatment.MethodsThe detailed literature search covered electronic databases including MEDLINE, PubMed, and Embase, as well as international conference abstract databases.ResultsPeer-reviewed literature analyzing the definite cost-effectiveness of CERA is scarce, and most of the available data originate from conference abstracts. Identified data are restricted to the treatment of anemia due to chronic kidney disease. Although the majority of studies suggest a considerable cost advantage for CERA, the published literature cannot easily be compared. While time and motion studies clearly indicate that a switch to CERA could minimize health care staff time in dialysis units, the results of studies comparing direct costs are more ambivalent, potentially reflecting the differences between health care systems and variability between centers.ConclusionAnalyzed data are predominantly insufficient; they miss clear evidence and have to thus be interpreted with great caution. In this day and age of financial restraints, results from well-designed, head-to-head studies with clearly defined endpoints have to prove whether CERA therapy can achieve cost savings without compromising anemia management.

The cost-utility of treating anemia with continuous erythropoietin receptor activator or Epoetin versus routine blood transfusions among chronic hemodialysis patients

“…Also, in Morocco, our study is the first to evaluate ESA at all. As reported recently by Schmid,9 there are few pharmacoeconomic studies evaluating the cost-utility of CERA; in 18 publications included in his analysis, only one study published as an abstract, reported data about the cost and QALY relative to CERA use in Brazilian dialysis patients; 40 using a model of a hypothetical cohort of CHP treated with CERA or epoetin, the analysis showed that epoetin treatment was more cost-effective than CERA treatment. Unfortunately, it was not possible to compare this study with our results since the access was limited to an abstract.…”

“…7 Understanding the relative cost-utility of those treatments is of importance to both clinicians and health care reimbursement authorities, as the acquisition costs of all ESAs are relatively high and are among the top drug expenditures of hospitals, health care payers, and providers. [7][8][9][10] Although all of previous health economic studies focused their analysis on short-acting ESA, CERA as the last one to be introduced in clinical practice has not been well studied yet. 1,7,9,11 The purpose of this study was to determine the cost-utility of treating dialysis patients with CERA once monthly or EpoB thrice weekly compared with a strategy of managing anemia without ESAs.…”

“…1,2 In our model, it was mandatory to include RBCT as a reference procedure; because at our knowledge, this is the first cost-utility analysis of ESA including CERA. 9,11 None of the previous cost-utility or cost-effectiveness studies had considered the last long-acting ESA for anemia in such population. Also, in Morocco, our study is the first to evaluate ESA at all.…”

Using of Long Action Erythropoes Stimulated Agents for Treatment of Anemia in Patients With Chronic Kidney Diseases v D St

“…Аналіз вартості лікування анемії у пацієнтів з ХХН на додіалізномі етапі показав, що лікування пегильованим еритропоетином- на 23,7% дешевше, ніж застосування дарбопоетину [3]. Аналіз вартості лікування анемії за даними електронних баз MEDLINE, PubMed, Embase та міжнародними базами абстрактів продемонстрував достовірні та переконливі докази економічних переваг використання ЕСЗ тривалої дії у хворих на ХХН [32].…”

Administration of erythropoiesis‐stimulating agents in patients undergoing haemodialysis: A time and motion study

“…International guidelines recommend treatment of anaemia due to CKD with erythropoiesis‐stimulating agents (ESAs) (Kidney Disease: Improvement Global Outcomes (KDIGO) Anemia Work Group ; McMahon et al ). The introduction of ESAs has largely replaced red cell blood transfusions for treating anaemia in this patient group, leading to reduced risks of iron overload, blood‐borne virus transmission and alloimmunisation (Schmid ).…”