Estimated prices of ESAs and supplemental iron
| Agent . | HCPCS code dosage . | Medicare payment limit (US$) . | Initial dose . | Regimen . | Price . |
|---|---|---|---|---|---|
| ESAs | |||||
| Darbepoetin alfa (non-ESRD) | 1 µg | 3.779 | 2.25 µg/kg SC | Weekly (SC) | $1,785.58 per 3-week cycle* |
| 500 µg SC | Every 3 weeks (SC) | $1,889.50 per 3-week cycle | |||
| Epoetin alfa (non-ESRD) | 1,000 U | 13.333 | 150 U/kg | 3 times weekly (SC) | $1,259.97 per 3-week cycle* |
| 40,000 U | Weekly (SC) | $1,599.96 per 3-week cycle | |||
| Iron supplements | |||||
| Iron dextran | 50 mg | 13.669 | Variable | IV | $273.38 per 1,000 mg |
| Ferric gluconate | 12.5 mg | 2.179 | Variable | IV | $174.32 per 1,000 mg |
| Iron sucrose | 1 mg | 0.234 | Variable | IV | $234.00 per 1,000 mg |
| Ferrous sulfate | N/A | N/A | Variable | Oral | Available over the counter. Prices at a sample of online retailers ranged from $0.01-$0.11 per 325-mg tablet |
| Agent . | HCPCS code dosage . | Medicare payment limit (US$) . | Initial dose . | Regimen . | Price . |
|---|---|---|---|---|---|
| ESAs | |||||
| Darbepoetin alfa (non-ESRD) | 1 µg | 3.779 | 2.25 µg/kg SC | Weekly (SC) | $1,785.58 per 3-week cycle* |
| 500 µg SC | Every 3 weeks (SC) | $1,889.50 per 3-week cycle | |||
| Epoetin alfa (non-ESRD) | 1,000 U | 13.333 | 150 U/kg | 3 times weekly (SC) | $1,259.97 per 3-week cycle* |
| 40,000 U | Weekly (SC) | $1,599.96 per 3-week cycle | |||
| Iron supplements | |||||
| Iron dextran | 50 mg | 13.669 | Variable | IV | $273.38 per 1,000 mg |
| Ferric gluconate | 12.5 mg | 2.179 | Variable | IV | $174.32 per 1,000 mg |
| Iron sucrose | 1 mg | 0.234 | Variable | IV | $234.00 per 1,000 mg |
| Ferrous sulfate | N/A | N/A | Variable | Oral | Available over the counter. Prices at a sample of online retailers ranged from $0.01-$0.11 per 325-mg tablet |
Drug prices were estimated from a third-party payer perspective, based on reimbursement rates from the Centers for Medicare and Medicaid Services that are widely accepted by providers, computed at the manufacturer’s average sales price. Other treatment-related direct and indirect costs were not considered, such as diagnostic laboratory tests. Actual treatment costs and reimbursement will vary considerably across regions, payers, institutions, and practices, as well as over time, and readers should consult current local cost information specific to their practice setting. Costs were based on Medicare Part B payment allowance limits effective July 1, 2018 (with no administration fees or other adjustments; Medicare Part B Drug Average Sales Price: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-Drugs/McrPartBDrugAvgSalesPrice/2018ASPFiles.html).
ESAs, erythropoiesis-stimulating agents; ESRD, end-stage renal disease; HCPCS, Healthcare Common Procedure Coding System; IV, intravenously; N/A, not applicable; SC, subcutaneously.
Based on an adult weighing 70 kg.