OBJECTIVES: : To evaluate the effectiveness and economic consequences of treating anemia with original erythropoietic agents in patients with chronic kidney disease (CKD) on dialysis and not yet on dialysis. METHODS: : The study is a cost-effectiveness and a cost-minimization analysis based on clinical studies derived from the systematic literature search covered Medline and the Cochrane Library.  To determine the economic benefit of using recombinant human erythropoietin (rEPO) agents in patients with CKD not on dialysis the comparison between rEPO-α and control group were conducted. The cost of  rEPO-α, haemodialysis sessions, total days of hospitalization, the frequency and the cost of treatment of myocardial infarction were taken into account. Cost-minimization analysis were conducted among original erythropoietic agents (rEPO-α, rEPO-β and Darbepoetin-α (DARB) to determine the one who provides the most cost savings in treatment of anemia in patients with CKD on dialysis and not on dialysis .  RESULTS: :  This pharmocoeconomic study suggests that rEPO-α therapy before dialysis may have a beneficial impact on delaying progression to dialysis, reducing hospitalization time and the frequency of cardio-vascular complications. The mean cost savings following the use of  rEPO-α before dialysis were RUR471,834 (€10,782.3 for June 2009) per patient  per year in comparison with control group. According to pharmacoeconomic evaluation the application of  rEPO-α for treatment anemia leads to considerable cost savings in patients with CKD not on dialysis (RUR43,761(€1000) per patient per year more than DARB) and in patients with CKD on dialysis (RUR83,957(€1918.6) per patient per year more than rEPO-β and RUR66,769(€1525.8) per patient per year more than DARB). CONCLUSIONS: : Correction of anemia with rEPO-α may reduce the utilization of health care resources and may lead to improved clinical and economic outcomes.