Use of darbepoetin alfa in the treatment of anaemia of chronic kidney disease: clinical and pharmacoeconomic considerations

Abstract

The introduction of erythropoiesis-stimulating agents (ESAs) into everyday clinical practice has greatly improved the care of patients with chronic kidney disease. ESAs have reduced the need for blood transfusions, improved survival, decreased cardiovascular complications and enhanced patient quality of life. The longer acting ESA, darbepoetin alfa (Aranesp(R)), which can be administered less frequently than traditional ESAs, provides further benefits to both patients and healthcare professionals relative to the epoetins. Clinical studies have shown that darbepoetin alfa administered once every 2 weeks or once every month allows enhanced convenience and cost savings with no compromise in efficacy, while maintaining patients within target haemoglobin ranges.

Fig. 1

Patients achieving Hb >11 g/dL after switching from recombinant human erythropoietin BIW or TIW weekly to once weekly dosing with darbepoetin alfa [40].

Fig. 2

Mean haemoglobin [95% confidence interval (CI)] (A) and mean dose (95% CI) levels (B) after switching from epoetin beta three times weekly to once weekly dosing with either darbepoetin alfa or epoetin beta [42].

Fig. 3

The MERCURIUS study: overall and by country cost per patient per year^* after switching from rHuEPO TIW to darbepoetin alfa Q2W. (A) Pharmacy labour costs; (B) dialysis unit materials and labour costs [56].