OBJECTIVE: Current National Institute for Health and Clinical Excellence (NICE) Clinical Guidelines on managing anemia in patients with chronic kidney disease (CKD) state that there is no evidence to differentiate between erythropoiesis-stimulating agents in terms of efficacy. Cost minimization analysis (CMA) is, therefore, an appropriate health economic approach in this therapy area. This CMA of epoetin zeta (Retacrit®), a biosimilar agent of epoetin alfa, versus current standard treatments was conducted from the perspective of NHS Scotland.
METHODS: A CMA of intravenous and subcutaneous epoetin, published in the full NICE Clinical Guidelines, was used as a framework for this cost analysis of epoetin zeta, the reference product epoetin alfa, epoetin beta and darbepoetin alfa. In both the NICE and this analysis, it was assumed that the cost difference of epoetin and iron administration would be negligible. Licensed epoetin doses were incorporated in this analysis.
RESULTS: This analysis demonstrates that epoetin zeta minimizes costs for treating anemia associated with CKD when compared with the reference product, epoetin alfa. The cost of epoetin zeta for a hemodialysis patient is £59.39/week (hemoglobin correction phase) and £29.70– £118.79/week (hemoglobin maintenance phase), based on a 70 kg patient. The corresponding cost for a patient treated with epoetin alfa is £67.32/week and £33.66–£134.64/week. The low drug acquisition cost for epoetin zeta could lead to potential cost savings.
CONCLUSION: CMA is an appropriate approach for managing anemia in people with CKD. This analysis demonstrates that the biosimilar product, epoetin zeta, minimizes treatment costs and would be of benefit to patients and NHS Scotland.
