Recombinant human erythropoietin vs transfusions in the treatment of anemia of prematurity. A cost-benefit analysis

Arch Pediatr Adolesc Med. 1994 Jun;148(6):582-8. doi: 10.1001/archpedi.1994.02170060036006.


Objective: To evaluate the costs relative to the benefits of using recombinant human erythropoietin (rHuEPO) therapy as an alternative to red blood cell (RBC) transfusions in infants with anemia of prematurity.

Design: A cost-benefit analysis of rHuEPO therapy was performed based on its use in very-low-birth-weight premature infants.

Setting and patients: Data were drawn from published studies or were provided by the University of Iowa Hospitals and Clinics, Iowa City.

Main outcome measures: Costs and benefits were analyzed as a comparison of incurred costs to averted costs. Incurred and averted costs of rHuEPO therapy and RBC transfusions included direct product costs and estimates of costs of adverse events. The analysis was viewed in terms of net savings. Sensitivity analysis was performed.

Results: The base case analysis yielded a net loss of $299.48 per infant. A 54% reduction in the direct product costs of rHuEPO therapy yielded a break-even point. No other variations in the sensitivity analysis resulted in a net savings.

Conclusion: Using assumptions based on the current state of clinical research, it appears that routine use of rHuEPO with supplemental RBC transfusions would not generate any cost savings as an alternative to RBC transfusions alone. As further evidence is compiled on the efficacy of rHuEPO therapy in very-low-birth-weight premature infants, the true costs may be better established.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anemia, Neonatal / drug therapy*
  • Anemia, Neonatal / therapy
  • Costs and Cost Analysis
  • Delivery of Health Care / economics
  • Delivery of Health Care / standards
  • Drugs, Investigational / economics
  • Drugs, Investigational / therapeutic use
  • Erythrocyte Transfusion / economics*
  • Erythropoietin / economics*
  • Erythropoietin / therapeutic use
  • Health Care Costs
  • Humans
  • Infant, Newborn
  • Infant, Premature, Diseases / drug therapy*
  • Recombinant Proteins / economics
  • Recombinant Proteins / therapeutic use
  • Treatment Outcome


  • Drugs, Investigational
  • Recombinant Proteins
  • Erythropoietin