The health(y) cost of erythropoietin in orthopedic surgery

Erythropoietin Protects against Local Anesthetic Myotoxicity during Continuous Regional Analgesia

“…50 The risk of rhEPO side effects combined to the extremely high cost of rhEPO has to be considered when minor clinical implications such as bupivacaine-induced myotoxicity are being discussed. 45,51 In conclusion, our findings demonstrate that bupivacaine-induced myotoxicity is associated with changes in mitochondrial structure and function in vivo. We show that rhEPO could protect against bupivacaine-induced myotoxicity, suggesting the existence of a protective mechanism in mitochondria.…”

Potential Cost Saving of Epoetin alfa in Elective Hip or Knee Surgery due to Reduction in Blood Transfusions and Their Side Effects: A Discrete-Event Simulation Model

“…While there are many possible reasons for EPO's inability to be adopted in clinical practice, the main reason appears to be its cost per regimen, which was originally around $2,250 [19] for the average 70 kg patient. When first brought to market, the cost per regimen (three weekly injections administered subcutaneously at 600 IU·kg −1 each) for the average 70 kg patient was approximately $268 per 20,000 IU.…”

Red blood cell transfusion triggers and transfusion alternatives in elective orthopedic hip and knee replacement surgery – a review

“…However, more evidence has been accumulating that shows Epo exceeds the costs of an allogeneic blood transfusion and therefore turns out to be not cost effective. [37][38][39][40] Intravenous (Iv) iron Anemia increases with age, with an overall prevalence of 11% in males and of 10% in females older than 65 years, if defined according to the World Health Organization (WHO) criteria. [41][42][43][44] One-third can be explained by nutritional causes (of which half are due to iron deficiency), one-third by anemia of chronic disease, and unexplained anemia in the remaining one-third of patients.…”