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Cost-effectiveness analysis of patients in peritoneal dialysis with methoxy polyethylene glycol-epoetin β versus darbepoetin α in Santiago De Compostela University Hospital Complex, Spain
  1. E. Echarri Arrieta,
  2. A. Fernandez-Ferreiro,
  3. R. Alonso Valente,
  4. M. Martínez-Guitián,
  5. L. Martínez-Calvo
  1. 1Complejo Hospitalario Universitario de Santiago de Compostela, Servicio de Farmacia, Santiago de Compostela, Spain
  2. 2Complejo Hospitalario Universitario de Santiago de Compostela, Servicio de Nefrologia, Santiago de Compostela, Spain

Abstract

Background Costs related to anaemia treatment in chronic kidney disease (CKD) patients are still under discussion. Near 80% of CKD patients included in a peritoneal dialysis program receive erythropoietin stimulating agents for the anaemia treatment.

Purpose 80% of chronic kidney disease (CKD) patients included in a peritoneal dialysis program receive erythropoietin stimulating agents for the anaemia treatment. The purpose of this study is to evaluate the cost-effectiveness of methoxy polyethylene glycol-epoetin β (C.E.R.A.) compared with darbepoetin alfa (DA) in a population of CKD patients in a peritoneal dialysis program.

Materials and methods 37 CKD patients undergoing peritoneal dialysis were included in the study: 28 with C.E.R.A. and 9 with DA. A cost-effectiveness analysis was developed to estimate the incremental cost-effectiveness ratio (ICER) of C.E.R.A. and DA in Spain under the hospital perspective for the last 12 months. Effectiveness, in terms of percentage of patients within range 11-12 g/dl haemoglobin levels, was calculated from the last three analysis. Demographic variables such as sex and age, and nutritional variables BMI and albumin, as dialysis efficiency factor value KTV were used to compare both groups. Unitary costs (¤2010) were obtained from de Spanish Catalogue of Medicines.

Results Both groups are similar taking into a account the nutritional, demographic and KTV value. The mean dose of C.E.R.A. was 92.3 mcg/dl while the mean dose of DA was 136.8 mcg/dl. Treatment with C.E.R.A. provided better results in effectiveness than DA (64.29% vs 44.44%). The average yearly cost in the study was ¤2,179 with C.E.R.A. and ¤2,767 with DA. Savings per patient treated with C.E.R.A. were ¤588 per year. Sensitivity analysis confirmed the stability of the results.

Conclusions In Santiago de Compostela University Hospital Complex treatment of anaemia in CKD patients included in a peritoneal dialysis program with methoxy polyethylene glycol-epoetin β is a cost reducing strategy in comparison with darbepoetin alfa.

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