OBJECTIVES: to estimate economic consequences and patients acceptance of a program proposing a switch toward self-injection of a recombinant Human erythropoïetin (r-HuEPO) NeoRecormon with Reco-Pen(r) in a population of adult patients on dialysis. METHODS: A cost-minimisation study was performed in a societal perspective to assess the economic consequences of the program proposing Reco-Pen(r), to facilitate self-injection in patients requiring a treatment with r-HuEPO. A random national sample of French patients in maintenance dialysis or in pre-dialysis were selected. A nurse was dedicated in each centre to educate and assist patients during the study period. Direct costs of injecting r-HuEPO before and after the program were estimated including purchase of the device and erythropoïetin, time spent by nurses for injection and education of patients or caregivers. Data were collected on all relevant items retrospectively and prospectively during a 2-month follow up period. An acceptance study was conducted including self-evaluation of pain during injection, easiness of use and satisfaction. RESULTS: One hundred twenty-four patients in 42 centres were enrolled in Fall 2001. Eighty-seven percent of patients were in maintenance therapy and the rest in correction phase. The satisfaction scores were positive in 80% of patients in terms of improved autonomy and comfort and 93% declared themselves ready to go on using the pen. The self-injection rates grew from 21% to 53%. The switch to Reco-Pen(r) of 100 patient x year was associated with an economic gain of €22,449 broken down as following: €18,725 corresponding to the benefit on r-HuEPO purchase cost, €3,500 corresponding to the costs avoided by reducing the number of injections performed by office-based nurses, and €224 due to the reduction of total time spent by nurses in the centres. CONCLUSIONS: The short-term acceptance of self-injection with Reco-Pen(r) in a program proposing the assistance of dedicated nurses is high and associated with an overall economic benefit.