J Clin Outcomes Manage
A comparison of home versus clinic administration of epoetin alfa in chronic kidney disease patients
Akers GR, Bucaloiu ID, Bermudez MC, Brown BL, Gill SS, Sartorius JA, Hartle JE
Abstract Objective: To compare clinical outcomes and estimate costs of home versus clinic administration of epoetin alfa (EPO) in non–end stage chronic kidney disease (CKD) patients enrolled in a pharmacy-driven anemia management program. Methods: Retrospective chart review of 156 patients. Data were collected on baseline estimated glomerular filtration rate, baseline hemoglobin, time to achieve target hemoglobin, percentage of time at target hemoglobin, baseline transferrin saturation (T-sat), percentage of time at target T-sat, and average dose of EPO used. Results: There were no significant differences between the home and clinic group in outcomes for time to goal hemoglobin (46 vs. 39 days; P = 0.784), percentage of time at goal hemoglobin range (55% vs. 59%; P = 0.531), or percentage of time at goal T-sat range (67% vs. 74%; P = 0.420). The clinic group was able to utilize an extended dose of EPO with more frequency (32 vs. 10 weeks; P = 0.001) and had a larger percentage of patients on extended dose EPO than the home group (79.2% vs. 54.4%; P = 0.001). Estimated cost savings ranged from $1092 to $6942 per year per patient who self administered EPO at home. Conclusion: There were no significant differences in clinical outcomes among patients enrolled in a pharmacy-driven anemia management program who received EPO in a clinical setting versus those who self administered at home. We estimated significant cost savings when self administration is utilized.
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