OBJECTIVES: Epoetin alfa (EPO) and darbepoetin alfa (DARB) are two erythropoietic stimulating therapies (ESTs) indicated for the treatment of chemotherapy-induced anemia. This analysis compared recent dosage patterns and associated drug costs of EPO and DARB in hospitalized cancer patients. METHODS: An analysis of electronic inpatient hospital records from the Premier Perspective Comparative Hospital Database was conducted. Study subjects were identified through hospitalizations recorded between July 2002 and March 2005 from over 500 hospitals nationwide. Included were patients ≥18 years of age with a primary admitting diagnosis of cancer who were treated with EPO or DARB during their hospital stay. Patients who had received renal dialysis were excluded. To minimize effect of outliers, 5% of patients with extreme doses in each group were excluded from the dosing analysis. Wholesale acquisition costs in 2005 (EPO: $0.01217/Unit, DARB: $4.36/mcg) were used to calculate EST costs. RESULTS: A total of 27,804 patients were identified (EPO: 24,814, DARB: 2,990). Mean age and gender distribution were comparable between groups (age: EPO 65.3 years, DARB 64.5 years; % women: EPO 53%, DARB 55%). Mean cumulative dose per inpatient stay was EPO 61,656 ± 50,274 Units and DARB 259 ± 340 mcg, corresponding to a dose only ratio of 238:1 (Units EPO: mcg DARB). Average treatment cost was significantly lower in the EPO group, compared to DARB (EPO: $750, DARB: $1,129; p<.0001). CONCLUSION: This analysis utilizing inpatient data demonstrated a dose only ratio between EPO and DARB of 238:1 in patients with cancer. DARB was found to cost 51% more than EPO based on the cumulative dose administered during hospitalization.