Cost Effective Analysis of Erythropoietin Alfa With Darbepoetin Alfa in CKD Patients

Abstract Background According to the Kidney Disease Improving Global Outcome Guidelines (KDIGO), Chronic Kidney Disease (CKD) is defined as abnormalities in kidney structure or function persisting for more than 3 months, with health implications. Aim This study aims to compare the cost-effectiveness of Erythropoietin alfa and Darbepoetin alfa in CKD patients. Material and Methods A Comparative Prospective Observational study was conducted among individuals visiting the Department of Nephrology, PSG Hospitals, Coimbatore, over a 6-month period. Sixty patients meeting the study criteria were included. Data on hemoglobin, serum urea, serum creatinine, and creatinine clearance were collected to assess effectiveness, while the costs of Erythropoietin alfa and Darbepoetin alfa were compared. Data were obtained from Patient Medical Records, and cost-effectiveness analysis was performed using Incremental Cost-Effectiveness Ratio (ICER). Results The study revealed that both Erythropoietin alfa and Darbepoetin alfa increased hemoglobin levels and creatinine clearance, while decreasing serum urea and serum creatinine levels consistently each month. Darbepoetin alfa was found to be more cost-effective than Erythropoietin alfa, with lower costs and greater effectiveness. Both agents effectively increased hemoglobin levels to the target range (8.5–9 g/dl), with subsequent decreases in creatinine levels noted after administration. However, Darbepoetin alfa demonstrated a greater efficiency in increasing hemoglobin compared to Erythropoietin alfa, with a cost of ₹32,688 less per patient over three months. Conclusion Darbepoetin alfa emerges as a more cost-effective option for managing anemia in CKD patients compared to Erythropoietin alfa.