Abstract
Introduction: Strategic management of anemia in patients with End-Stage Renal Disease (ESRD) requires comprehensive clinical and pharmacoeconomic evaluations. This study aimed to elucidate and compare the efficacy, pharmacodynamic profile, and cost-utility indices of CinnaPoietin (epoetin beta isoform) versus PDpoietin (epoetin alfa isoform) in hemodialysis patients.
Methods: This applied cross-sectional study was modeled within the Health Technology Assessment (HTA) framework with a one-year time horizon. Simultaneous Cost-Utility Analysis (CUA) and Cost-Effectiveness Analysis (CEA) were performed by extracting the Incremental Cost-Effectiveness Ratio (ICER) After confirming the normal distribution of the variables using the Kolmogorov–Smirnov test, the equivalence and differences in outcomes were evaluated through parametric and non-parametric tests at a significance level of P < 0.05..
Finding: Mean hemoglobin in the CinnaPoietin group (10.76±1.45 g/dL) and PDpoietin group (10.20±1.39 g/dL) showed no significant difference (P=0.160). Dialysis adequacy index (Kt/V) was significantly higher in the CinnaPoietin group (1.29±0.35) compared to PDpoietin (1.14±0.31) (P=0.011). Safety profiles were similar. ICER per one-unit improvement in Kt/V was 205,411,676 Rials and per g/dL hemoglobin increase was 64,285,710 Rials, both below the willingness-to-pay threshold, indicating high cost-effectiveness. Mean total cost-utility score in the CinnaPoietin group (6.76) was significantly different from PDpoietin (8.02) (P=0.004).