OBJECTIVES: This retrospective analysis aimed to compare erythropoiesis-stimulating agent (ESA) dosing patterns and costs in chemotherapy-induced anemia (CIA) inpatients. METHODS: Electronic records from the Premier hospital database (2006Q1-2011Q1) were used to identify inpatients aged ≥18 years that had a diagnosis for cancer, received chemotherapy during hospitalization, and received epoetin alfa (EPO) or darbepoetin alfa (DARB). Exclusion criteria were: a diagnosis of chronic kidney disease, diagnosis of myelodysplastic syndrome, receipt of renal dialysis, or receipt of both ESAs. The observation period consisted of the inpatient stay. The ESA dose ratio (Units EPO: mcg DARB) was calculated using the mean cumulative dose of EPO and DARB. ESA treatment costs were determined using cumulative dose and December 2010 wholesale acquisition costs. RESULTS: A total of 20,132 inpatient stays (EPO: 15,221; DARB: 4,911) were identified.  The EPO group was older than the DARB group (65.0 vs. 63.7 years, respectively; P<0.001), had a lower proportion of females (53.8% vs. 55.7%, respectively; P=0.019), and had a longer mean length of stay (LOS) (13.2 vs. 12.1 days, respectively; P<0.001). The mean cumulative dose was EPO 57,248 Units and DARB 211 mcg, resulting in a dose ratio (Units EPO: mcg DARB) of 271:1. Mean ESA treatment costs were higher for DARB than for EPO (EPO: $867 vs. DARB: $1,130; P<0.001). CONCLUSIONS: In this analysis of CIA inpatient records, a dose ratio (Units EPO: mcg DARB) of 271:1 was observed.  Mean ESA treatment costs were observed to be approximately 30% higher for the DARB group than for the EPO group despite a longer LOS for the EPO group.