OBJECTIVES: To assess and compare costs and effects of Mircera vs. Aranesp treatment of pre-dialysis patients. METHODS: A systematic review of medical data bases according to EBM principles was conducted. Efficacy and safety data for both treatment options were compared. No significant differences in clinical efficacy and safety of both treatments were identified. Cost-minimization analysis was conducted in order to compare costs. The analysis was performed from the perspective of public payer in a two-year time horizon. Only direct cost data, gathered in three reference centers in Poland, were taken into account (drug’s costs, drug administration and adverse events costs). According to Polish HTA Agency guidelines costs were discounted by 5%. Dosing schemes for both drugs were assumed based on the assumptions of the National Health Fund Therapeutic Area Program for the CKD patients in pre-dialysis period: Mircera- 50 μg s.c.(mean monthly dose), Aranesp: 10 µg once weekly, or 20 µg – once per 2 weeks or 40 µg once monthly i.v. or s.c (mean dosing was calculated). Sensitivity analysis was done to test the robustness of the results. Results were tested for changes in the value of accounting points defined by the payer (+/-20%), discounting rate for costs and changes in drug dosing. RESULTS: CMA showed savings of 1 194 PLN (1 EUR= 4.55 PLN) per patient with Mircera treatment vs. Aranesp in the 2 year horizon. Savings were due to the once monthly Mircera administration scheme. Results of the basic analysis were confirmed by the sensitivity analysis. CONCLUSIONS: Mircera treatment of CKD patients in pre-dialysis period is as effective and safe as Aranesp therapy, but offers savings to the public payer.