COST CONSEQUENCE ANALYSIS OF DARBEPOETIN ALFA FOR THE TREATMENT OF ANEMIA DUE TO CHRONIC KIDNEY DISEASE (CKD) IN GREECE
Author(s)
Kourlaba G1, Boletis I2, Goumenos D3, Iatrou C4, Papagiannopoulou V5, Tritaki G5, Maniadakis N6
1Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), Athens, Greece, 2Medical School of Athens, National and Kapodistrian University of Athens School of Medicine, Athens, Greece, 3Nephrology and Renal Transplantation Department, Patras University Hospital,, Patras, Greece, 4General Hospital of Nikaia, Athens, Greece, 5AMGEN Hellas, Marousi, Greece, 6National School of Public Health, Athens, Greece
OBJECTIVES: Conduct an economic evaluation of darbepoetin alfa for the treatment of anaemia due to chronic kidney disease (CKD) compared to other erythropoiesis stimulating agents (ESAs) in patients on haemodialysis (HD) or peritoneal dialysis (PD) in Greece. METHODS: A decision tree model was developed to compare overall costs per patient in control of darbepoetin alfa to other ESAs under different haemoglobin (Hb) concentrations and CKD patients. It estimates the economic impact of treating CKD patients on dialysis with darbepoetin alfa, originator and biosimilar short-acting ESAs and pegylated epoetin beta to different Hb target strategies, 10(±1) g/dL and 11(±1) g/dL, over 1 year. The effectiveness of “% patients under anaemia control” was defined as the number of patients being alive, not hospitalized, nor transfused during the analysis period. Clinical inputs depend on Hb target strategy and not on ESAs as extracted from published studies. Cost inputs are drug acquisition, administration and clinical event costs, the last comprising hospitalisation and blood transfusion costs (2014). Analysis was conducted from public third-party-payer perspective. RESULTS: For both Hb target strategies in patients on HD or PD, darbepoetin alfa demonstrated the lowest overall costs per patient in control followed by short-acting originator ESAs, whereas pegylated epoetin beta and short-acting biosimilar ESAs showed the highest overall costs per patient in control. As clinical event costs are identical across all ESAs, the overall costs per patient in control are mainly affected by drug acquisition costs and by ESAs doses. Treatment with darbepoetin alfa at Hb target 11(±1) g/dL is associated with the lowest overall costs per patient in control at €8,210 and €6,689, for patients on HD or PD, respectively. CONCLUSIONS: Darbepoetin alfa may be the most cost saving treatment compared to other ESAs for the management of anaemia (CKD) in patients on HD or PD in Greece.
Conference/Value in Health Info
2014-11, ISPOR Europe 2014, Amsterdam, The Netherlands
Value in Health, Vol. 17, No. 7 (November 2014)
Code
PUK15
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Urinary/Kidney Disorders