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Valutazione economica di epoetina alfa nel trattamento dell’anemia indotta da chemioterapia: una revisione sistematica della letteratura

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Giornale Italiano di Health Technology Assessment

Summary

Cancer patients have innately low erythropoetin levels, and those receiving chemotherapy in particular exhibit a higher frequency of anaemia. Furthermore, consequences of anaemia can erode the patient’s quality of life (QoL) and result in a lack of energy and a decrease in cognitive function. Current treatments for chemotherapy induced anaemia (CIA) include packed RBC transfusions, iron supplementation and erythropoiesis-stimulating agents (ESAs). The most prominent benefits of ESAs (epoetin alfa, epoetin beta and darbepoetin alfa) are evident in studies demonstrating their ability to significantly raise haemoglobin levels, reduce transfusion requirements and improve functional status and QoL.

The aim of this literature review is to verify whether epoetin alpha represents a best alternative, in terms of costs and effectiveness, in comparison with pharmacological alternatives (epoetin beta and darbepoetin alfa) used in the treatment of CIA. The economic evaluation has been appraised according to two methodologies: cost-minimization analysis and cost-effectiveness analysis.

Three cost-minimization analyses demonstrate that direct medical costs for darbepoetin alfa (DARB) therapy are consistently higher than for epoetin alfa (EPO); two cost-effectiveness analyses show that EPO is more cost-effective than DARB. However, the acceptability of resulting values must be valued with relation to the willingness to pay from decision-makers in each country.

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  1. Wolters Kluwer Health | Adis International Ltd., Milano, Italia

    Roberto Ravasio (Economista sanitario)

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  1. Roberto Ravasio
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Ravasio, R. Valutazione economica di epoetina alfa nel trattamento dell’anemia indotta da chemioterapia: una revisione sistematica della letteratura. G. Ital. Health Technol. Assess 2, 37–45 (2009). https://doi.org/10.1007/BF03320717

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