Analisi di minimizzazione dei costi degli agenti stimolanti l’eritropoiesi nel trattamento dell’anemia indotta da chemioterapia

Abstract

Administration of Erythropoietin Receptor Agonists (ERAs) is indicated as standard of care for treatment of anaemia in cancer patients. Considering the Italian setting, only limited information is available on the economic impact of ERAs epoetin alfa, epoetin beta and darbepoetin alfa in the treatment of anaemic cancer patients. So, this analysis was conducted to compare cost per patient of each of these agents. Data for this retrospective study were derived from the administrative database of a middle-sized (half a million beneficiaries) Local Health Unit in Northern Italy. A sample was built by selecting all patients who, between 2005 and 2006, had a cancer diagnosis and had received at least two prescription for ERA. The study evaluated durations of treatments and weekly costs associated with either treatment. The original sample consisted of 322 patients (mean age: 65.6 years, 52.5% females). The mean duration of treatment was 7.52 weeks for epoetin alfa and 8.68 weeks for darbepoetin alfa (p = 0.16). The annual mean cost of treatment was €2,413.23/patient treated with epoetin alfa and €3,492.23/patient (+45%) treated with darbepoetin alfa (p < 0.001). Based on data from an Italian Local Health Unit, we performed an analysis focused on the use of ERAs in the treatment of anemia in cancer patients. Analysis results were interesting, particularly as attempt to estimate the annual mean cost of treatment between epoetin alfa and darbepoetin alfa, which resulted consistent with a previous European study. This evaluation showed that epoetin is a cost-saving strategy compared with darbepoetin alfa in the treatment of cancer patients anaemia. An important limitation was that patient records did not provide an indicator of disease severity.