Darbepoetin alfa versus epoetin alfa for treatment of chemotherapy-induced anemia: A health economic evaluation

Objectives: Erythropoiesis-stimulating proteins (ESPs) are used in the treatment of chemotherapy-induced anemia (CIA) with the aim of improving quality of life and reducing the need for blood transfusions. A retrospective analysis based on data from a single institution compared costs and effectiveness of two ESPs, epoetin alfa (Eprex) and darbepoetin alfa (Aranesp), in consecutively treated patients over a 2-year period.

Methods: Data from all patients treated for CIA between January 1, 2007 and December 31, 2008 with one of the two ESPs – epoetin alfa (40 000 IU once weekly) or darbepoetin alfa (500µg every 3 weeks) - were analyzed. Total and per patient costs and costs per clinical response (hemoglobin ≥11 g/dL) were calculated, based on drug acquisition costs for the ESPs.

Results: 161 patients were treated with epoetin alfa (799 doses; mean 4.96 doses per patient) and 52 with darbepoetin alfa (94 doses; mean 1.81 doses per patient). Total and per-patient costs were 8 682 226 CZK (€331 003.66) and 54 461 CZK (€2076.29) for epoetin alfa versus 2 578 984 CZK (€98 321.92) and 49 596 CZK (€1 890.81) for darbepoetin alfa. The response rate was higher (58% vs 47%, not statistically significant), and the mean cost per treatment response was lower, with darbepoetin alfa, at 85 966 CZK (€3 277.39) versus 115 763 CZK (€4 413.38).

Conclusions: Our results indicate that darbepoetin alfa is associated with lower drug acquisition costs than epoetin alfa, as well as a lower cost per treatment response, for treatment of CIA. This study was supported by the research project: VZ MSM 00216819

Disclosure: All authors have declared no conflicts of interest.