Clinical evidence indicates that the SC route of epoetin (epoetin alfa and epoetin beta) is more efficient clinically than IV, which is reflected by smaller epoetin dose requirements (e.g. Kaufman et al 1998; NeoRecormon Product Information dated 6 December 2005). Whilst the dose reduction for patients changing from IV to SC epoetin is variable, a recent meta-analysis showed 30% dose reduction by the SC route, resulting in significant cost savings (Besarab et al 2002). Furthermore, the NeoRecormon Product Information states that 'generally the subcutaneous maintenance dose is approximately 20% to 35% lower than the intravenous maintenance dose'. However, studies monitoring the conversion patients treated with SC epoetin alfa to IV epoetin alfa showed only 15% increase in dose requirements in Swedish haemodialysis patients (Torbjörn et al 2005) and 8.7% in Australian hemodialysis patients (Pussell and Walker 2003). Unlike epoetin, there is no difference in efficiency of darbepoetin alfa by route of administration (Vanrentergham et al 2002; Cervelli et al 2005).