OBJECTIVES : Chronic kidney disease (CKD) is a costly public health issue, which affects 13.4% of the population globally. Anemia is a common complication in CKD patients, resulting in reduced health-related quality of life and high healthcare costs. The objective of this analysis is to estimate the direct medical care cost offsets of the investigational agent roxadustat for the treatment of anemia in patients with incident dialysis-dependent (ID) CKD from a US healthcare perspective.

METHODS : Data from the roxadustat global phase 3 program were used to estimate the incidence of iron supplementation/rescue therapy use (i.e. intravenous iron, erythropoiesis-stimulating agents [ESAs] or red blood cell transfusions) and major adverse cardiovascular events (MACE+) for roxadustat compared with ESAs in ID patients with anemia of CKD. MACE+ included myocardial infarction, stroke, hospitalized unstable angina, hospitalized congestive heart failure, cardiovascular death, and other death. Published US cost data were used to estimate event costs. Drug acquisition costs for roxadustat and ESAs were not considered. A hypothetical cohort of 10,000 US adult ID patients (90% undergoing hemodialysis, 10% undergoing peritoneal dialysis) with treatable anemia was modeled to determine net medical care cost offsets annually and cumulatively compared with ESAs over a 4-year time horizon.

RESULTS : Preliminary results for patients with ID CKD show that, compared with ESAs, roxadustat could produce sizeable net medical care cost offsets from decreases in iron supplementation/rescue therapy usage and MACE+. Cumulative medical care cost offsets for iron supplementation/rescue therapy use and MACE+ were an estimated US$156,498 and US$12,882,500, respectively, for roxadustat compared with ESAs for the entire cohort of patients with ID CKD.

CONCLUSIONS : This analysis provides evidence that treatment with roxadustat in ID patients with anemia of CKD could result in considerable medical care cost offsets for roxadustat compared with ESAs for iron supplementation/rescue therapy usage and MACE+.