A retrospective database analysis of erythropoiesis‐stimulating agent treatment patterns and associated healthcare resource use in patients with non–dialysis‐dependent chronic kidney disease–related anaemia in Japan

Aim This study was conducted to evaluate clinical characteristics, treatment patterns, and healthcare resource use (HCRU) for patients in Japan with non–dialysis‐dependent chronic kidney disease (CKD) and anaemia. Methods This retrospective, longitudinal, epidemiological database extraction study used the JMDC Claims Database, comprising ~9.4 million unique beneficiaries. The observation period for anaemia and erythropoiesis‐stimulating agent (ESA)/iron treatment was 1 January 2015 to 31 December 2018, and for HCRU and costs was 1 April 2016 to 31 March 2018. The non–dialysis‐dependent CKD anaemia population, and the ESA treatment, iron treatment, and no‐treatment cohorts were evaluated. Patient characteristics, treatment patterns, and outcomes were summarised descriptively. Results The non–dialysis‐dependent CKD anaemia population included 5908 patients (7.9%), with 464 patients in the ESA treatment cohort, 809 patients (13.7%) in the iron treatment cohort (13.7%), and 4405 (74.6%) patients in the no‐treatment cohort. The prevalence of patients prescribed an antihypertensive, antidiabetic, and/or antihyperlipidaemic medication generally increased with increasing baseline CKD stage. Proportions of no treatment for anaemia decreased while ESA treatment increased with increasing CKD stage; ESA treatment increased with decreasing baseline haemoglobin levels. Patients in the ESA treatment cohort generally had more frequent events associated with HCRU and higher costs from HCRU‐associated activities (e.g., inpatient and outpatient care, pharmacy). Conclusion As CKD severity increased, anaemia management changed from iron use or no treatment to ESA use; however, anaemia may be undertreated across all CKD stages. ESA‐treated patients incurred greater HCRU‐associated costs relative to other patients with non–dialysis‐dependent CKD anaemia in Japan. Summary at a Glance In this retrospective database analysis, as chronic kidney disease (CKD) severity increased, anaemia management changed from iron use or no treatment to erythropoiesis‐stimulating agent (ESA) use; however, anaemia may be undertreated across all stages of CKD. ESA‐treated patients incurred greater healthcare resource use–associated costs relative to other patients with non–dialysis‐dependent (NDD)‐CKD anaemia in Japan.