Abstract
Objectives
A cost analysis comparing darbepoetin-alfa (DARB), epoetin-alfa (EPO-A) and epoetin-beta (EPO-B) in the treatment of chemotherapy-induced anemia in Belgium concluded that costs of patients treated with DARB were significantly lower than costs of EPO-A- or EPO-B-treated patients. The objective of the present study was to adapt the Belgian analysis to the Italian setting, estimating differences in costs between erythropoiesis-stimulating agents (ESAs), considering ex-factory drug prices.
Methods
The absence of Italian longitudinal databases required to adapt the Belgian epidemiology and treatment pattern data to the Italian setting by adjusting the differences between countries. Belgian unit costs were replaced with the Italian ones. Italian ex-factory drug prices were used, and sensitivity analyses were performed using drug public prices. Costs were analyzed using a mixed-effects model stratified for propensity score quintiles.
Results
After finding similarities between the countries and adjusting for the Italian-specific setting, total management costs (including hospitalization, procedures, ESAs and other pharmaceutical costs) with DARB (Euro, year 2010) were €6,996 per patient, 24% and 19% lower than with EPO-A (p < 0.0001) and EPO-B (p = 0.0022), respectively. Anemia related costs (including hospitalization, procedures, ESAs and blood transfusion costs) with DARB were €1,786 per patient, 35% lower than with EPO-A (p < 0.0001). A statistically non-significant lower trend was shown when compared to EPO-B. Similar results were obtained with drug public prices.
Conclusions
Total and anaemia-related costs were lower in patients receiving DARB compared to those receiving EPO-A or EPO-B. These findings are consistent with those of the Belgian analysis, and confirm the economic efficiency of the administration of DARB in Italy.
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Grabbi, E., Lucioni, C., Duran, A. et al. Analisi dei costi associati agli agenti stimolanti l’eritropoiesi nel trattamento dei pazienti con anemia indotta da chemioterapia in Italia. Pharmacoeconomics-Ital-Res-Articles 14, 91–100 (2012). https://doi.org/10.1007/BF03337457
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DOI: https://doi.org/10.1007/BF03337457