Erythropoietin Stimulating Agents (ESAs) are widely used by chronic kidney disease patients who suffer with renal associated anemia. Until recently there have been only two ESAs currently available in the Australia: epoetin alfa/Eprex® (Janssen Cilag) and darbepoetin alfa/Aranesp® (Amgen). Following expiry of the Eprex® patent earlier this year another agent, epoetin beta/NeoRecormon® (Roche) has also become available . While ESAs provides significant benefits to the patients, with reduced morbidity and mortality, it comes at a considerable economic cost.