EFFECTIVENESS OF EPOETIN ALPHA VERSUS DARBEPOETIN IN CHEMOTHERAPY-INDUCED ANAEMIA IN THE GERMAN SETTING

Author(s)

Nadja Ezzat, MSc, Manager Health Economics1, Bernd Brüggenjürgen, MD, MPH, Coordinator Health Economics2, Stefan N Willich, MD, MPH, MBA, Director21Alpha Care GmbH, Celle, Germany; 2 Charite University Medical Center, Berlin, Germany

OBJECTIVES: To analyze the effectiveness of Darbepoetin alpha and Epoetin alpha administered in patients with chemotherapy-induced anaemia (CIA) in the German setting considering the dosing schedules recommended in Germany. METHODS: Published prospective, randomized and controlled studies with either Epoetin alpha administered once weekly (EPO-QW), Darbepoetin administered QW (DARB-QW) and once every three weeks (DARB-Q3W) were extracted. Mean haemoglobin area-under-the-change-curve (HB-AUC) was selected as the effectiveness parameter, calculated by inclusion of all available haemoglobin values in the chosen time frame of 12 weeks. Mean administered doses and transfusion requirements were analysed. Number of study patients were accounted for. RESULTS: Eleven study arms were identified satisfying the inclusion criteria. Mean baseline HB for EPO-QW, DARB-QW and DARB-Q3W varied between 9.5 - 10.4 g/dl, 9.4 - 9.9 g/dl, and 9.8 - 9.9 g/dl respectively. The increase in HB levels from baseline to week 12 varied between about 1.0 g/dl - 2.9 g/dl, 1.1 g/dl - 1.6 g/dl, and about 1.0 g/dl. Calculated mean HB-AUC value for EPO-QW, DARB-QW and DARB-Q3W were 11.75, 8.84 and 8.08, respectively. Mean administered doses reported were 39,949 IU / week and 42,714 IU / week for EPO-QW, 2.2 µg/kg weekly, 1.59 µg/kg weekly, 2.05 µg/kg weekly for DARB-QW and 1.87 µg/kg weekly mean dose per kg for DARB-Q3W. Information on transfusion rates differed, for two study-arms transfusion requirements were not reported at all. CONCLUSION: Comparative studies are not available for the recommended and labeled regimens in Germany. Quality and amount of reported data needed for comparing clinical effectiveness from different study arms differ very much. Administered doses, transfusion rates and detailed HB increase were not available for all studies. Considering HB-AUC as the key comparison criterium Epoetin alpha administered once weekly is more effective.

Conference/Value in Health Info

2007-10, ISPOR Europe 2007, Dublin, Ireland

Value in Health, Vol. 10, No. 6 (November/December 2007)

Code

CN3

Topic

Clinical Outcomes

Topic Subcategory

Comparative Effectiveness or Efficacy

Disease

Oncology

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