Chemotherapy-induced anemia is currently treated with recombinant human erythropoietin growth factors (rHu-EGFs) or transfusion. Currently, most studies find that that blood transfusion is more cost effective compared to rHu-EGFs due to the high cost and relatively small quality of life (QOL) improvements from the drugs. OBJECTIVES: To measure the cost effectiveness of using blood transfusion vs. rHu-EGFs in chemotherapy-treated cancer patients from the societal perspective and cost per quality-adjusted life-year (QALY) approach. METHODS: A spreadsheet model was used to evaluate the cost effectiveness of erythropoietin (EPO) or darbepoietin (DARB) plus transfusion when needed, compared to transfusion only. The model applied clinical and QOL data from previous clinical trials and existing literature, in an expected present value backwards induction model using DEALE survival modeling to estimate cost per QALY. In the base case, patients were 60 years old, weighed 60 kg and used the manufacturer's recommended doses for chemotherapy-related anemia. The model's time horizon was one year. A sensitivity analysis was performed to determine model robustness. RESULTS: In the base case and relative to infusion only, for each patient who received EPO, the cost per QALY was $25,152, whereas, the cost per QALY was $ 45,646 for DARB. The sensitivity analysis suggested that the model was only sensitivity to QOL assumption, when the probability of infusion and anemia was altered by 25%, the cost per QALY values for EPO were $24,847 - $25,473 and $21,419 - $30,039, respectively. Also, an 81% reduction in DARB dose or price would be needed to equalize the cost of DARB treatment with that of EPO. CONCLUSIONS: This economic model demonstrates that treating chemotherapy-related anemia using rHu-EGFs is more cost-effective than transfusion only. Also, current clinical data suggests that there are no significant QALY differences between the rHu-EGFs. Thus, EPO would be the dominant alternative.