OBJECTIVES: Anemia occurs in 40% of patients undergoing treatment for solid tumors. Aim of this study was to perform cost-minimization analysis of using different erythropoiesis-stimulantig agents (ESA) – epoetin alfa (Eralfon®, biosimilar of Russian origin) and darbepoetin alfa (Aranesp®) – for managing chemotherapy-induced anemia (CIA) in adult cancer patients in actual practice in Russia.

METHODS: Analysis of the published clinical trials was conducted to evaluate efficacy and safety of using different ESA. MS Excel based model of medical care patients with anemia has been developed for 1 patient with solid tumor undergoing chemotherapy taking into account the possibility of individual selection of the dose for epoetin alfa (initial dose 12000 IU 3 times per week) and for darbepoetin alfa (initial dose 500 mcg every 3 weeks) after 4 weeks of treatment. To evaluate the real clinical practice of managing anemia in adult patients undergoing cancer treatment in Russia interview of experts was conducted. To measure costs of treatment chemotherapy-induced anemia for the state budget were used “cost-minimization” analysis. Direct medical costs included drugs, therapy monitoring (Hb concentration), hemotransfusions, side effects correction and were calculated from the Russian healthcare system perspective.

RESULTS: A survey of experts showed that the treatment with ESA required the individual selection of the dose after 4 weeks of treatment and using of darbepoetin alfa is associated with a higher risk of thrombosis, hypertension and myalgia. The total costs of treatment CIA per patient were $2111 with epoetin alfa and $3932 with darbepoetin alfa. The difference amounted to $1821 in favor of the epoetin alfa (rate for June 2018).

CONCLUSIONS: Managing CIA with biosimalar epoetin alfa in adult cancer patients was effective and economically justified treatment option in real clinical practice in Russia.