OBJECTIVES : Two studies (TUNE and RIKAS) were conducted in Spain to describe (among other endpoints) annual healthcare resource utilisation (HCRU) and associated costs in non-dialysis-dependent (NDD) and dialysis-dependent (DD) patients with chronic kidney disease (CKD)-related anaemia.

METHODS : Both TUNE and RIKAS were retrospective, longitudinal, observational studies. While TUNE was based on patient’s chart data, RIKAS was based on the BIG-PAC database. Inclusion criteria were similar, except that TUNE focused on adult NDD-CKD (stage 3b–5) patients receiving ESA at study entry, while RIKAS included adult NDD-CKD and DD-CKD populations. The following HRCU and associated costs were evaluated in both studies: consultations, emergency room visits, hospitalisations, laboratory tests, surgical procedures, and treatment/prescriptions.

RESULTS : In TUNE, 430 patients with anaemia of NDD-CKD (stage 3b–5) treated with ESAs were followed for up to 24 months. Of the 116 patients who received short-acting ESAs, the mean±SD costs were €447±909 per patient per month. The main contributing factors were hospitalisations (€104±650) and ESA treatment (€199±299). For the 289 patients who received long-acting ESAs, mean±SD costs were €646±1,282 per patient per month. The main contributors to these costs were ESA treatment (€399±1,152) and concomitant IV iron treatment (€123±429).

In RIKAS, 59,778 NDD-CKD and 346 DD-CKD patients were included during 12-month follow-up, of whom 20,303 and 315 patients had anaemia, respectively. Within NDD-CKD and DD -CKD groups, patients with anaemia had more HCRU and associated costs than non-anaemic patients. Within the anaemic population, NDD and DD ESA-treated patients had more HCRU than non-ESA treated patients. The extra HCRU was due to GP and nephrologist consultations, emergency room visits, hospitalisations, laboratory tests, and surgical procedures.

CONCLUSIONS : CKD-related anaemia is associated with an increase in HRCU and its associated costs, compared with non-anaemic CKD. There is room for improving anaemia management among patients with CKD, including new treatments.