Time savings associated with C.E.R.A. once monthly: a time-and-motion study in hemodialysis centers in five European countries

Abstract

Objective:

This time-and-motion study aimed to quantify healthcare personnel time associated with routine anemia-management tasks for maintenance therapy with C.E.R.A. (continuous erythropoietin receptor activator) that treats anemia with once-monthly injections versus other erythropoiesis-stimulating agents (‘Other ESAs’), including shorter-acting ESAs (epoetin alfa, epeotin beta) and darbepoetin alfa.

Methods and design:

This was a non-interventional, observational study where patients were treated for anemia according to individual center practices. Time taken to complete frequent anemia-management tasks for both groups (C.E.R.A. vs. ‘Other ESAs’) was recorded and potential annual time savings per patient and per center following assumed 100% uptake of C.E.R.A. once monthly were estimated.

Results:

For ‘Other ESAs’, the average total time spent per patient per year on frequent anemia management-related tasks ranged from 48 minutes in Spain to 265 minutes in Poland. For C.E.R.A. once monthly, the average total time spent per patient per year ranged from 12 minutes in Spain to 39 minutes in Poland, a reduction in actual time spent of 76–89% versus ‘Other ESAs’. 100% adoption of C.E.R.A. once monthly may result in average annual time savings of 26–553 hours, a reduction of 67–95% depending on center size and frequency distribution of ‘Other ESAs’.

Limitations:

Due to variability in treatment practices between centers (differences in task, description and frequency distribution of ‘Other ESAs’) and the small numbers of centers participating in each country, it is difficult to generalize annual per patient time results to reflect each country. Per center results should be interpreted with caution as they were derived based on specific center sizes that may not reflect typical center sizes in the country.

Conclusions:

Adoption of C.E.R.A. once monthly could offer substantial time savings on frequent anemia management-related tasks versus ‘Other ESAs’; allowing re-allocation of scarce resources to other aspects of patient care.

Keywords::

• Anemia
• Chronic kidney disease
• Erythropoiesis-stimulating agents
• Time savings

Transparency

Declaration of funding

This study was sponsored by F. Hoffmann-La Roche Ltd, Basel, Switzerland. All authors had full access to the data and participated in reviewing and interpreting the data and the paper.

Declaration of financial/other relationships

E.D.C. and M.R-C. are full-time employees of United BioSource Corporation; F.D., K.K., W.K., F.M. and G.V. declare that they have no conflict of interest.

Acknowledgments

The authors would like to thank Tanya Chaudry at Complete HealthVizion, UK, for her assistance with writing and revising the draft manuscript, based on detailed discussion and feedback from all authors. Writing assistance was funded by F. Hoffmann-La Roche Ltd. Primary responsibility for opinions, conclusions and interpretation of data lies with the authors. All authors read and approved the final version of this manuscript.

Notes

*MIRCERA is a registered trademark of F. Hoffmann-La Roche Ltd, Basel, Switzerland