Anemic cancer patients in the UK may soon have 6 erythropoiesis-stimulating agents (ESAs) available through the National Health Service.
The National Institute for Health and Care Excellence (NICE) has drafted a guidance recommending 5 epoetins—2 alfas, 1 beta, 1 theta, and 1 zeta—and 1 darbepoetin to treat anemia in adult cancer patients receiving chemotherapy.
NICE has started a consultation on the guidance, and it will be open for comment until May 9.
To inform NICE on the clinical effectiveness of the 6 ESAs, an independent appraisal committee looked at results from several clinical trials and reviewed the existing guidance.
The committee concluded that the ESAs were effective at increasing hemoglobin levels and managing anemia when compared to current standards of care. The drugs reduced the need for blood transfusions in patients receiving cancer treatment.
Furthermore, analyses suggested the ESAs are cost-effective. However, the draft guidance recommends that healthcare professionals offer patients the appropriate ESA with the lowest cost.
The guidance recommends the ESAs for their approved indications.
Epoetin alfa (marketed as Eprex and Binocrit) and epoetin zeta (marketed as Retacrit) are approved in the UK to treat anemia and reduce transfusion requirements in adult patients receiving chemotherapy for solid tumors, malignant lymphoma, or multiple myeloma. Patients must be at risk of transfusion, as assessed by their general status (eg, cardiovascular status, pre-existing anemia at the start of chemotherapy).
Eprex, Binocrit, and Retacrit are available in pre-filled syringes at net prices of £5.53, £5.09, and £5.66 per 1000 units, respectively.
Epoetin beta (marketed as NeoRecormon) and Epoetin theta (marketed as Eporatio) are approved to treat symptomatic anemia in adult patients with non-myeloid malignancies who are receiving chemotherapy.
NeoRecormo is available in a pre-filled syringe at a net price of £3.51 per 500 units, and Eporatio is available in a pre-filled syringe at a net price of £5.99 per 1000 units.
Darbepoetin alfa (marketed as Aranesp) is approved to treat symptomatic anemia in adult patients with non-myeloid malignancies who are receiving chemotherapy. It is recommended for use at hemoglobin concentrations of 100 g/l or lower, with target values up to 120 g/l. Aranesp is available in a pre-filled syringe at a net price of £14.68 per 10 micrograms.
Costs exclude tax and may vary in different settings. For more information, see the draft guidance.
