Impact analysis of the less frequent dosing of Erythropoiesis Stimulating Agents in patients on chronic haemodialysis in Europe

22 augustus 2019

The goal of the study (‘Mercurius study') was to map the quantitative and qualitative impact of the less frequent dosing of ESA's in chronic kidney patients on haemodialysis. Hict performed this impact analysis in 40 dialysis centres over 9 European countries. The Mercurius study was later on expanded to the Canadian market.

Project Highlights

  • Customer: Amgen Europe
  • Main Goal: Determine the qualitative and quantitative impact of less frequent dosing of ESAs in chronic HD patients
  • Main Result: Report on the impact of less frequent dosing for all participating European centres, scientific publication and poster presentations, recommendations, best practices and benchmarks on processes for all participating centres


For the analysis an impact model was developed existing of a conceptual model, a generic model and a hospital-specific model:

  • The conceptual model describes the three dimensions of this impact analysis: organisation, processes and activities.
  • The generic model contains the basics for research and describes the standard processes, activities and functions involved in the flow of an ESA injection throughout the hospital.
  • The entire flow of the ESA injection was followed through every individual hospital and hospital-specific data were collected to result in hospital-specific models.

A calculation model was also developed in order to calculate the impact of the less frequent dosing of ESA's on the costs of the individual hospitals. The qualitative impact was defined by means of structured interviews and observations in the hospitals.


  • Global confirmation of the significant cost savings because of the less frequent dosing of ESA
  • Definition of the qualitative advantages for each participating hospital
  • Publication of these results in international journals and on international and national conferences
  • Strengthening of the commercial position of Aranesp® in the participating hospitals
  • Recommendations, best practices and benchmarks for the participating hospitals
  • Development of a solid partnership between Amgen and the participating hospitals
AMGEN eu multicentre cost study

Less frequent dosing of erythropoiesis stimulating agents in patients undergoing dialysis: a European multicentre cost study

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AMGEN swiss haemodialysis centres

Potential contribution of less frequently dosed erythropoiesis stimulating agents to the operational efficiency of anaemia management: A study in 4 Swiss haemodialysis centres - Swiss society of nephrology Lausanne 2007

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AMGEN pilot study switzerland

Potential Contribution of Every Other Week Administered Erythropoiesis Stimulating Agents to the Operational Efficiency of Anemia Management in a Haemodialysis Center: an Explorative Pilot Study in a Haemodialysis Center in Switzerland - Swiss society of nephrology solothurn 2006

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AMGEN European society of clinical pharmacy Vienna 2006

Economic Benefits of Less Frequent Dosing of Erythropoietic Stimulating Proteins in Patients on Dialysis - European society of clinical pharmacy Vienna 2006

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Improving Anemia Management With Less Frequently Dosed Erythropoiesis Stimulating Agents - Era Edta Congress 2007

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AMGEN presentation

Less frequent dosing of erythropoiesis stimulating agents may result in cost savings in european dialysis centers

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