In Search of Predictors of Switching Between Erythropoiesis-Stimulating Agents in Clinical Practice: A Multi-Regional Cohort Study

Ingrasciotta, Ylenia; Belleudi, Valeria; Trotta, Francesco; Addis, Antonio; Fontana, Andrea; Chinellato, Alessandro; Ientile, Valentina; Tari, Daniele Ugo; Roberto, Giuseppe; Pastorello, Maurizio; Scondotto, Salvatore; Cananzi, Pasquale; Traversa, Giuseppe; Davoli, Marina; Rossi, Mariangela; Trifirò, Gianluca

doi:10.1007/s40259-019-00385-y

Cited by 2 publications

(4 citation statements)

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“…Due to the NHS setting from which the data are derived and because healthcare data collection is mandatory as per Italian law, the healthcare data used in this study are considered to have a high level of completeness. Italian claims databases have been frequently used to conduct drug utilization, safety and effectiveness studies 20 and, specifically, the databases included in this study have already been used for pharmacoepidemiology research on the use and comparative effectiveness of originator and biosimilar drugs in the context of the same project as the present study 12,13,21‐25 …”

Section: Methodsmentioning

confidence: 99%

“…Italian claims databases have been frequently used to conduct drug utilization, safety and effectiveness studies 20 and, specifically, the databases included in this study have already been used for pharmacoepidemiology research on the use and comparative effectiveness of originator and biosimilar drugs in the context of the same project as the present study. 12,13,[21][22][23][24][25]…”

Section: Data Sourcementioning

confidence: 99%

“…12 In 2007, the European Medicines Agency (EMA) approved the marketing of biosimilar epoetin alpha, whose use can reduce ESA pharmaceutical expenditure by 20-30%. 13 In Italy, a significant crossregional heterogeneity in biosimilar uptake was observed between 2009 and 2013, due to different regional healthcare policies concerning biosimilar use. 12 Moreover, almost 20% of patients started ESA treatment inappropriately, 14 and this may lead to a worsening of clinical outcomes as well as incurring additional, preventable costs.…”

Section: Introductionmentioning

confidence: 99%

“…In 2007, the European Medicines Agency (EMA) approved the marketing of biosimilar epoetin alpha, whose use can reduce ESA pharmaceutical expenditure by 20‐30% 13 . In Italy, a significant cross‐regional heterogeneity in biosimilar uptake was observed between 2009 and 2013, due to different regional healthcare policies concerning biosimilar use 12 .…”

Section: Introductionmentioning

confidence: 99%

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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?

Ingrasciotta

Sultana

Formica

et al. 2020

Pharmacoepidemiology and Drug

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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.

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Section: Methodsmentioning

confidence: 99%