Abstract: SA-PO1105
Cost-Effectiveness Evaluation of Hypoxia-Inducible Factor-Prolyl Hydroxylase (HIF-PF) Inhibitors for Treatment of Anemia of CKD
Session Information
- Kidney Replacement Therapy and Care Delivery Innovations
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Author
- Maeda, Kunimi, Maeda Institute Renal Resach, Kawasaki, Kanagawa, Japan
Background
Renal anemia is an important complication for patients with chronic kidney disease and is closely related to life prognosis. The main treatment of renal anemia for hemodialysis patients was using recombinant human erythropoietin (ESA) treatment, which appeared in the 1980s. On the other hand, in 2019, HIF-PH inhibitors, which increase endogenous erythropoietin, were launched as a novel oral treatment for renal anemia and began clinical use. Since its launch, many clinical trials have proven non-inferiority in clinical efficacy compared to exogenous erythropoietin administration. HIF-PH inhibitors are less expensive than ESA formulations, which are injectable drugs, and may be the first-line drug in terms of cost-effectiveness. However, since it is an oral drug, it is important to comply with dosage compliance.
Methods
In 31 outpatient hemodialysis patients (22 males, 9 females, mean age 70.2 years, average dialysis history 81 months) who maintained Hb concentrations ≥11.0 g/dL for more than half a year with ESA preparation (Darbepoetin alfa 10μ~ 20 μ/week) were treated with HIF-PH inhibitors (Daprodustat 6mg) after obtaining written consent, were taken orally on the day of dialysis treatment, and the cost reduction effect and anemia maintenance effect (change in Hb concentration) were examined for 6 months before and 6 months after administration. Iron supplementation was carried out as needed with reference to iron metabolism indicators (serum Fe concentration, serum ferritin concentration, iron saturation).
Results
The drug price for 6 months after taking HIF-PH inhibitors was significant reduced from 305,760 yen to 295,152 yen compared to using ESA preparations. Hb concentrations also before and after Daprodustat administration decreased from 12.2 g/dl to 11.6 g/dl significantly, but the clinic's anemia management target Hb concentration range (11.0~12.9 g/dl) was maintained. In some patients, the Hb concentration increased with Daprodustat (13.0 g/dL or more) and the number of days of administration was reduced from 3 to 2 days per week.
Conclusion
Renal anemia treatment with HIF-PH inhibitors was considered to be an effective treatment option from the perspective of cost-effectiveness compared to treatment with existing ESA preparations. It is important to treat renal anemia considering the patient's pathological conditions and medical drug price.
Acknowledgment
Dr. Ken Tsuchiya is currently supported this study.