Amgen Canada – Impact analysis of the less frequent dosing of Erythropoiesis Stimulating Agents in chronic haemodialysis patients and process optimisation in 2 Canadian hospitals

Amgen is a leading biotechnology company. Its drug Aranesp® - an Erythropoiesis Stimulating Agent (ESA), used for e.g. the treatment of anaemia in chronic kidney patients, - has the benefit that it needs to be applied less frequently than other ESA's.

Description | business case

After the success of the Mercurius study in 40 European dialysis centres, this study was also conducted in 2 Canadian hospitals (Toronto General Hospital and Grand River Hospital). The objective of the study in Canada:

  • mapping of the quantitative and qualitative impact of the less frequent dosing of ESA's in chronic haemodialysis patients compared to other ESA's; 
  • a profound analysis of the processes - directly or indirectly – linked to ESA and recommendations for the optimisation of these processes. 


For this analysis an impact model (geared to the Canadian market) was developed, consisting 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 forms the basis of research and describes the standard processes, activities and functions that are part of the flow of an ESA injection throughout the hospital. 
  • The entire flow of the ESA injection was followed throughout each individual hospital and hospital-specific data were collected, to result in hospital-specific models. A calculation model was also developed 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 at the hospitals. At the same time recommendations were elaborated for the optimisation of the processes in 2 Canadian hospitals.


  • general confirmation of the significant cost savings by the less frequent dosing of ESA; 
  • definition of the qualitative advantages for each participating hospital;
  • optimisation of the pharmacy processes, stocks, back office processes, distribution of medicinal products, quality, etc. through structured analyses; 
  • publication of these results during the yearly conference of The Canadian Society of Hospital Pharmacy;  
  • consolidation of the commercial position of Aranesp® at the Grand River Hospital and Toronto General Hospital (UHN);  
  • development of a solid partnership between Amgen and the 2 Canadian hospitals; 
  • recommendations, best practices and benchmarks for the 2 hospitals.

Your contact person

Ann Tanghe
Senior Manager
Ann Tanghe
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