Cost and efficacy after conversion of Darbepoetin-α to Epoetin-α in hemodialytic patients

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A new study conducted on hemodialytic patients suggests that conversion of Darbepoetin-α to Epoetin-α does not improve cost and efficacy. This study was published in the journal, Giornale italiano di nefrologia.

In this study, 12 clinically stable patients on hemodialysis were administered Darbepoetin-α (DARB) for a period of 16 months. These single weekly doses of Darbepoetin-α were converted to EPO-α and administered 2-3 times/week. Dose-conversion ratio (DCR) of 200 IU EPO-α = 1 mcg DARB was used to calculate initial dose of EPO-α. Six months before the conversion, the mean Hb value was between 11 and 12 g/dL while the monthly dose of DARB remained unchanged/reduced during the last 3 months.

It was found that during the last month of treatment with DARB, the mean Hb value of the group was 11.4±0.5 g/dL while the mean weekly dose/patient was 24±12 mcg. Later on, after 2 months of using EPO-α, the mean Hb value dropped to 10.8±0.7 g/dL while the mean monthly dose/patient was 5.667±2.229 IU, which corresponded to a DCR of 234. In order to achieve Hb values above 11 g/dL, doses of EPO-α were steadily increased up to a maximum of 10.000±5.461 IU/patient, bringing the DCR to 414.

From the above results obtained, it can be evident that converting darbepoetin-α to an ESA with a seemingly lower cost, may result in worsening of anemia in hemodialysis patients, leading to increased expenditures.

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