Drug utilization and cost for erythropoiesis-stimulating agents in a long-term care resident population with chronic kidney disease.
Autor: | Lafeuille MH; Groupe d'analyse, Ltée, Montréal, Québec, Canada., Bailey RA, Vekeman F, Kilpatrick BS, Senbetta M, Piech CT, Lefebvre P |
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Jazyk: | angličtina |
Zdroj: | The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists [Consult Pharm] 2010 Aug; Vol. 25 (8), pp. 493-500. |
DOI: | 10.4140/TCP.n.2010.493 |
Abstrakt: | Objective: To compare drug-utilization patterns and costs in patients with chronic kidney disease (CKD), not on dialysis, yet receiving epoetin alfa (EPO) or darbepoetin alfa (DARB) in a long-term care setting. Design: A retrospective analysis of pharmacy dispensing from January 2007 through March 2009, was conducted using the AnalytiCareSM LTC database. Setting: Long-term care. Patients, Participants: Patients>or=18 years of age, with >or=1 EPO or DARB dose dispensed, were included. Patients dispensed both agents, diagnosed with cancer, receiving chemotherapy, radiation therapy, or renal dialysis, were excluded. Main Outcome Measures: Mean cumulative erythropoiesis-stimulating agent (ESA) dose was used to calculate drug cost (using April 2009 wholesale acquisition cost) and dose ratio (Units EPO:mcg DARB). Results were also stratified by payer types. Results: A total of 2,259 patients were identified (EPO 1,640; DARB 619). EPO patients were slightly older (76.1 vs. 74.8 years of age, P=0.021), with similar proportion of women, compared with DARB patients. Mean (SD) cumulative dose was 98,420 (122,381) Units for EPO and 360 (428) mcg for DARB, resulting in a dose ratio of 273:1 (Units EPO:mcg DARB). The corresponding drug cost was 42% higher with DARB than with EPO ($1,734 vs. $1,217, P<0.001). Stratified analysis by payer types yielded similar results (dose ratios: 299:1 and 270:1 [Units EPO:mcg DARB]); cost premiums: 30% and 44% for Medicare Part A/Facility and Medicare Part D/Medicaid groups, respectively. Conclusions: This study of long-term care CKD patients receiving ESAs reported 42% higher drug cost with DARB compared with EPO and a dose ratio of 273:1. |
Databáze: | MEDLINE |
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