Hörbrand F, Rottenkolber D, Fischaleck J, Hasford J
Kassenärztliche Vereinigung Bayerns, Referat Vertragspolitik und Arzneimittel, München, Germany.
Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Ludwig-Maximilians-Universität und Münchner Zentrum für Gesundheitswissenschaften, München, Germany.
Gesundheitswesen. 2014 Nov;76(11):e79-84. doi: 10.1055/s-0033-1361111. Epub 2014 Feb 3.
Renal anemia is a serious concern for morbidity and lower quality-of-life of patients suffering from chronic kidney disease resulting in a high economic burden when administering erythropoiesis-stimulating agents (ESAs). The aim of this study was to estimate erythropoietin-induced treatment costs in patients suffering from renal anemia undergoing dialysis treated with originator or biosimilar drugs.
A retrospective analysis was undertaken of ESA-related pharmacotherapy between January 1, 2008 and December 31, 2010 based on treatment and pharmacy claims data of 16,895 dialysis patients contained in the database of the Association of Statutory Health Insurance Physicians, Bavaria. All patients received an ESA treatment (ATC code B03XA) and chronic maintenance hemodialysis due to chronic kidney disease stage 5.
Total drug expenditures for ESA-originators and biosimilars amounted to € 78.447 million for the 3-year study period. In hemodialysis patients cumulative defined daily doses (DDDs) were 7,727,782.14. Mean costs per DDD were € 10.79 (originators) and € 8.56 (biosimilars). A biosimilar substitution quota of 50% provides a savings potential of € 6.14 million [range € 3.07-9.22 million (25-75% quota)].
A more common biosimilar prescription in renal anemia patients suffering from chronic kidney disease provides a noteworthy economic savings potential.
肾性贫血是慢性肾脏病患者发病和生活质量下降的严重问题,在使用促红细胞生成素(ESA)时会带来高昂的经济负担。本研究的目的是评估接受原研药或生物类似药治疗的肾性贫血透析患者中促红细胞生成素诱导的治疗成本。
基于巴伐利亚法定医疗保险医师协会数据库中16895例透析患者的治疗和药房报销数据,对2008年1月1日至2010年12月31日期间与ESA相关的药物治疗进行回顾性分析。所有患者因慢性肾脏病5期接受ESA治疗(ATC编码B03XA)和慢性维持性血液透析。
在为期3年的研究期间,ESA原研药和生物类似药的总药物支出达7844.7万欧元。在血液透析患者中,累积限定日剂量(DDD)为7727782.14。每DDD的平均成本为10.79欧元(原研药)和8.56欧元(生物类似药)。50%的生物类似药替代率可节省614万欧元[范围为307 - 922万欧元(25 - 75%替代率)]。
在患有慢性肾脏病的肾性贫血患者中更普遍地开具生物类似药处方可带来显著的经济节省潜力。