Pharmacoeconomic aspects of use of erythropoietin drugs in patients on hemodialysis in Ukraine

Abstract

OBJECTIVES: The number of patients suffering from chronic kidney disease (CKD) is about 10% of the total world population and 50% of patients with hypertension and diabetes. About 3400 patients with CKD in Ukraine are treated by hemodialysis. All these patients need treatment of anemia that associates with CKD by erythropoietins (EPs). In Ukraine as well as alfa- and beta-erythropoietins a fundamentally new product – continuous erythropoietin receptor activator (CERA) are recommended. Its main feature - administration twice a month in treated dose and once a month in maintenance dose, while others EPs are administrated 2-3 times a week. The purpose of research is comparative pharmacoeconomic evaluation of maintenance treatment of anemia in patients with CKD on hemodialysis stage by different drugs of erythropoietin. METHODS: Decision tree and cost-effectiveness analysis were used. The costs for EP drugs were determined according to the price list Pharmacy (2011). The data about equivalent doses of different EPs and their effectiveness are taken from the results of randomized clinical trials phase III MAXIMA, PROTOS and RUBRA. RESULTS: Showed that prolonged use of CERA, which is administrated once a month, effectively maintained stable hemoglobin level previously is achieved by the administration of shorter-acting EPs (3 times a week). With appropriate regimen of administration in equivalent doses (according to the instruction of CERA) the average costs of CERA treatment per patient on hemodialysis are $173/week (i/v route of administration) and $130/week (s/c route of administration). The average costs for using the shorter-acting EP drugs are $267-194/week and $133-182/week respectively. CONCLUSIONS: The use of CERA in patients with CKD on hemodialysis at the compensative stage instead of shorteracting EPs saves about 5-35% of cost for anemia pharmacotherapy. The effectiveness and safety of therapy do not change.