Table 1.
Sources of uncertainty and parameter values assumed and probability distributions simulated
| Source | Description | Value | Distributiona | Monte Carlo quantile |
|---|---|---|---|---|
| USRDS1 | Number of HD patients per year | Mean: 500,000 SD: 50,000b |
N (500,000, 50,000) | x#HD |
| Mutell et al15 | Assumed reduction factor for ESAs and IV iron associated with ferric citrate usage | ESAs: 0.1, 0.2, 0.3 Fe: 0.3, 0.4, 0.5 |
TRI (0.05, 0.15, 0.1), TRI (0.15, 0.25, 0.2), TRI (0.25, 0.35, 0.3), TRI (0.35, 0.45, 0.4), TRI (0.45, 0.55, 0.5) | xRF1, xRF2 |
| CMS base rate costs PPPY (2011)c | ESA PPPY costs | Lower (Aranesp®): US$1,426 Middle (Epogen®): US$12,243 Upper: US$13,467b |
TRI (1,426, 13,467, 12,243) | xESA |
| IV iron PPPY costs | Lower (Ferrlecit®): US$432 Middle (Venofer®): US$1,057 Upper: US$1,162b |
TRI (432, 1,162, 1,057) | xFe | |
| CMS actual utilization (2011) PPPY costsc | ESA PPPY costs | Lower (Aranesp): US$543 Middle (Epogen): US$9,545 Upper: US$10,499b |
TRI (543, 10,499, 9,545) | xESA |
| IV iron PPPY costs | Lower (Ferrlecit): US$209 Middle (Venofer): US$1,148 Upper: US$1,263b |
TRI (209, 1,263, 1,148) | xFe |
Notes:
N (μ, σ) = normal distribution with mean μ, and standard deviation σ, and TRI (a, c, b) = triangular distribution with lower bound a, upper bound c, and mode b;
upper bound set to middle value plus 10%;
RED BOOK™ (Truven Health Analytics New York, NY, USA) values and CMS base rate and actual utilization of ESA and IV iron used to derive PPPY costs of ESA and Fe. Epogen® and Aranesp® are manufactured by Amgen Inc., CA, USA; Venofer® is manufactured by American Regent, Inc., NY, USA; and Ferrlecit® is manufactured by Sanofi US, Bridgewater, NJ, USA.
Abbreviations: CMS, Centers for Medicare and Medicaid Services; ESA, erythropoietin-stimulating agent; HD, hemodialysis; IV, intravenous; PPPY, per-patient-per-year; SD, standard deviation; USRDS, United States Renal Data System.