It seems that more erythropoietin (EPO) is required when given intravenously (IV) than when given subcutaneously (SC). Estimates of the magnitude of this difference vary widely, impeding development of economic models in this area. Concerns about pure red cell aplasia led our program to switch from SC to IV EPO, so we studied the impact of this change on the cost of anemia therapy.
All in-center hemodialysis patients who had received EPO for at least 3 months prior to and following conversion to IV EPO were studied. Data was obtained retrospectively for 1 year prior to and prospectively for 1 year following conversion. The costs of anemia therapy (EPO, transfusions and iron) were calculated from the hospital's perspective.
158 patients were studied. One month after switching, the hemoglobin fell significantly, reaching a nadir at 3 months. This triggered more use of EPO, iron and transfusions. By month 7 hemoglobin levels had returned to initial levels, with a median rise in EPO dose of 1,250 units/week (p
A cost analysis of a conversion from intravenous (IV) to subcutaneous (SC) epoetin a in patients receiving chronic in-center hemodialysis (HD).
This retrospective analysis compared epoetin a drug costs during a 6-month period of IV usage (July to December 2010, period 1) to a 6-month period of SC usage (July to December 2011, period 2) in four large in-center HD units. Data were collected from quarterly counts of HD patients receiving epoetin a and monthly inventory billing records.
622 HD patients who received IV epoetin a (period 1) were compared to 609 HD patients who received SC epoetin a (period 2). A 12.6% decrease in dose was observed. The average weekly cost of epoetin a was USD 173.02 per patient during the IV period versus USD 151.20 per patient during the SC period. This equated to a yearly cost savings of USD 1,135 per patient with SC epoetin a.
The switch from IV to SC epoetin a was successfully implemented in all four centers and realized significant cost savings.
We sought to evaluate epoetin alfa drug costs in hemodialysis (HD) patients after a province-wide switch from multidose vials (MDV) to prefilled syringes (PFS).
A retrospective study of epoetin alfa drug costs and estimated doses based on these costs during a six-month period of MDV usage (2007) were compared to a PFS usage period (2008). Data were collected from quarterly counts of HD patients receiving epoetin alfa in the Manitoba Renal Program (MRP) and monthly inventory billing records.
756 patients who received epoetin alfa MDV were compared to 799 patients who received epoetin alfa PFS. Average weekly dose calculated from drug costs was 13,282 units (MDV) versus 11,689 units (PFS). Average weekly costs were $195.71 (MDV) versus $183.23 (PFS). This translated to an estimated $12.48 per patient per week in savings ($518,519 annual savings across the Manitoba Renal Program).
The switch from epoetin alfa MDV to epoetin alfa PFS realized cost savings, likely as a result of reduced drug wastage.