Epogen® Carve Service

Epogen® is a standard medication that is prescribed for treating anemia in patients with kidney failure. Epogen
replaces a protein called erythropoietin that normally is made by the kidney. Erythropoietin causes the bone
marrow to produce oxygen-carrying red blood cells, elevating or maintaining the red blood cell level and
decreasing the need for transfusions in these patients. Monthly Epogen bills can exceed $20,000 and represent over 20% of a patient’s bill. With markups of 700% at dialysis centers, Epogen is a significant cost driver to plans.
DCC’s Epogen Carve service creates high dollar savings while promoting greater patient independence. We assist in obtaining home infusion training and drop ship the Epogen through affiliated service providers directly to the patient’s home. Savings are relative to the level of Epogen prescribed, but can exceed $100,000 annually for members with significant Epogen usage.

Key Features

• DCC acquires the prescription, even from reluctant centers.
• DCC works with the member to assess possible training needs.
• No provider payment issues, since the prescription can be filled at a lower cost by DCC’s pharmacy vendor.
• Takes advantage of the self-injection skills of patients who already do so due to diabetes or other co-morbidities.

Benefits

• Significant cost containment opportunity without the need for plan changes.
• Encourages member independence
• Works well in conjunction with other home-based treatments

Methodology

Administration of Epogen is by subcutaneous injection, a procedure many members are able to perform at home. It is not uncommon for Epogen dosages, and the associated cost to increase over the course of dialysis treatment. Savings are typically in the range of 90% compared to normal in-center charges.  In most states, members are entitled to obtain their prescription from their physician, if they desire to self-administer Epogen outside the dialysis center setting. DCC has a proven method to help members acquire prescriptions if they are willing to self-administer at home.