After the peak incidence rate of PRCA associated with epoetin-α treatment in 2002 [6], few cases of PRCA caused by biosimilar epoetin products have been reported, these included 2 cases for HX575 (binocrit; Sandoz GmbH, Kundl, Austria) in 2012 (1 confirmed, 1 possible) [16], 1 case for epoetin-θ/epoetin-β/darbepoetin-α in 2013 [17], and this case for epoetin-ζ during the study period of PASCO II. Here, EPO is linked to pure red-cell aplasia.