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The Economic Impact of Pre-Dialysis Epoetin Alfa on Health Care and Work Loss Costs in Chronic Kidney Disease: An Employer's Perspective.

Moyneur E, Bookhart BK, Mody SH, Fournier AA, Mallett D, Duh MS

Analysis Group, Boston, Massachusetts.

ABSTRACT The objective of the study was to quantify the direct and indirect incremental costs of epoetin alfa (EPO) therapy for anemia in pre-dialysis chronic kidney disease (CKD). Using employer claims data from January 1998 to January 2005, direct (medical and pharmacy) and indirect (sick leave and disability) costs were compared between CKD-anemic patients treated with EPO before dialysis (n = 199) and those not treated with an erythropoiesis-stimulating therapy (EST) (n = 196). Among the results, incremental direct and indirect cost savings for EPO-treated patients were $1443 and $328 per member per month (PMPM) (p < 0.001), respectively, compared to non-EST-treated patients with anemia. After multivariate adjustments, direct and indirect costs remained significantly lower by $852 and $308 PMPM (p < 0.001), respectively, for the EPO-treated group. Direct costs during the first 6 months of dialysis also were significantly lower for the EPO-treated group (who received EPO before dialysis), by $1515 PMPM (p = 0.0267, in multivariate regression). In conclusion, anemic CKD patients treated with EPO before dialysis had significantly lower direct and indirect costs compared to non-EST-treated patients. (Disease Management. 2008;11:49-58).

Published 18 February 2008 in Dis Manag, 11(1): 49-58.
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