Objective: This study assessed costs related to anemia management in a reference dialysis center. The study also explored the potential benefit of efficiency improvement and costs reduction with the use of C.E.R.A., a novel continuous erythropoietin receptor activator that is effective for treating anemia with a once monthly injection. Methods: This study was conducted at the Hospital do Rim from Universidade Federal de São Paulo (dialysis center) where 208 patients make use of human recombinant erythropoietin (ESA) for anemia management. Structured interviews with personnel were arranged to identify workflow for anemia management. Time spent in each activity was registered using a stop watch by a trained professional. Time spent in less frequent activities or in activities were the direct relation with anemia management could not be done were not taken into consideration for this study. For valuing time and supplies the dialysis center's costs data was considered. Results: Total time spent for ESA administration by the dialysis center for the treatment of 208 patients was 75 days or R$19,758. Assuming the usage of C.E.R.A. in 100% patients of the center, the time spent by the staff would be 10 days or R$2683, representing an 86% reduction versus current practice. Costs of supplies needed for the administration were R$28,863 for those patients receiving conventional ESA and R$774 if patients would have received C.E.R.A. As a result, potential total savings generated with the use of C.E.R.A. was R$ 45,165 per year in this dialysis center or R$ 217/patient/year. Conclusion: The study suggests that the adoption of once-monthly C.E.R.A. can bring substantial savings for the dialysis center: R$44,847 per year or R$216 per patient per year. Once-monthly C.E.R.A. could also improve resource utilization and enable health care staff to focus more time on other aspects of patient care.