Direct healthcare costs of chronic kidney disease management in Italy: What cost-savings can be achieved with higher biosimilar uptake and more appropriate use of erythropoiesis-stimulating agents?
| Autor: | Mariangela Rossi, Giuseppe Traversa, Pasquale Cananzi, Janet Sultana, Maurizio Pastorello, A Aiello, Daniele Ugo Tari, Ylenia Ingrasciotta, Alessandro Chinellato, Dario Formica, Valentina Ientile, Gianluca Trifirò, Salvatore Scondotto, Rosa Gini, Domenico Santoro |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
pharmacoepidemiology Epidemiology Anemia medicine.medical_treatment erythropoiesis‐ stimulating agents 030226 pharmacology & pharmacy direct healthcare costs Cohort Studies 03 medical and health sciences 0302 clinical medicine Maintenance therapy hemic and lymphatic diseases Health care medicine Humans Pharmacology (medical) Erythropoiesis 030212 general & internal medicine Renal Insufficiency Chronic Intensive care medicine Biosimilar Pharmaceuticals health care economics and organizations Dialysis Biosimilars business.industry Biosimilar claims database Health Care Costs Pharmacoepidemiology medicine.disease chronic kidney disease erythropoiesis-stimulating agents Italy Hematinics business Kidney disease Cohort study |
| Zdroj: | Pharmacoepidemiology and drug safetyREFERENCES. 30(1) |
| ISSN: | 1099-1557 |
| Popis: | Purpose Erythropoiesis-stimulating agents (ESAs), are used for treating chronic kidney disease (CKD)-related anemia, contributing to CKD costs. The study was aimed at investigating direct healthcare costs of CKD patients treated with ESAs and the potential savings achievable by increasing the use of biosimilars and preventing inappropriate ESA use. Methods A multi-center, cohort study was conducted using claims databases of five large Italian geographic areas. Yearly mean direct healthcare costs per patient were estimated, stratifying by CKD stage. The total yearly cost and potential savings related to ESA use were estimated: (a) considering 25/50/75% of originator ESA substitution with biosimilars; (b) eliminating inappropriate ESA dispensing. Results During the study period, the ESA-related yearly mean cost represented 17% of total yearly costs in stage I-III, decreasing to 13% in stage IV-V and 6% in dialysis. Among originator users, assuming a 25% of biosimilar uptake, the annual cost-savings of ESA treatment would represent 10.5% of total ESA costs in CKD stage I-V and 7.7% in dialysis. Among incident ESA users for which hemoglobin levels were available, 9% started inappropriately ESA treatment, increasing to 62.0% during the first year of maintenance therapy. Hypothesizing prevention of the first inappropriate ESA dispensing, the total yearly cost-savings would amount to €35 772, increasing to €167 641 eliminating the inappropriate dispensing during maintenance therapy. Conclusions Higher use of lowest cost ESA, prevention of inappropriate ESA use as well as other strategies aimed at slowing down the progressive renal impairment are essential for minimizing clinical and economic burden of CKD. |
| Databáze: | OpenAIRE |
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