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논문분류	춘계학술대회 초록집
제목	Comparison of the Efficacy and Cost of Erythropoiesis-Stimulating Agents Administered to Hemodialysis Patients
저자	Yoojin Choi
출판정보	2026; 2026(1):
키워드	Chronic kidney disease, Anemia, Erythropoiesis-stimulating agents
초록	Objectives: Anemia in chronic kidney disease (CKD) patients is associated with increased cardiovascular complications and mortality. Therefore, the administration of erythropoiesis-stimulating agents (ESAs) until renal transplantation is indispensable. This study compared the effects and costs of ESAs in CKD patients undergoing hemodialysis, aiming to reduce medical costs. Methods: This retrospective cohort study comprised patients aged over 18 years, undergoing hemodialysis at Asan Medical Center from January 1, 2018, to July 2, 2019, and receiving ESA [epoetin alfa (EPO-α, Epokine®), darbepoetin-alfa (DA-α, Nesp®), and methoxypolyethyleneglycol-epoetin-beta (continuous erythropoiesis receptor activator, CERA, Mircera®)] for anemia treatment. The mean hemoglobin concentrations and the costs incurred [mean ESA dose (units/month) × price/unit (during 2018 and 2023)] for the EPO-α, DA-α, and CERA groups over a year were compared. Results: The mean hemoglobin levels exhibited no significant difference among the three groups (P = 0.159). Although the mean erythropoietin resistance index (ERI) values were significantly higher in the EPO-α group (P = 0.002), they remained below 300 IU/kg/week during the 12-month follow-up, not meeting the definition of ESA resistance. Based on the 2018 and 2023 prices, the DA-α group incurred the lowest mean cost of 71,142.3 ± 33,312.6 won and 49,745.5 ± 23,293.4 won, respectively (P < 0.001). Conclusion: While the three groups exhibited no significant differences in hemoglobin levels, the DA-α group achieved the target range at the lowest mean cost. To reinforce these results, a comprehensive study using data from the Health Insurance Review and Assessment Service of the Republic of Korea is warranted.
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