Abstract | AIM: This study was designed to evaluate the cost-effectiveness of AST-120, an oral adsorbent that attenuates the progression of chronic kidney disease. METHODS: We developed a Markov model with six health states, including four levels of serum creatinine, haemodialysis and death, using data from a randomized clinical trial conducted in Japan. Direct costs relevant to chronic kidney disease were calculated from a Japanese reimbursement perspective. Projected quality-adjusted life years (QALY) and costs were compared between the AST-120 and placebo groups. The target population was nondiabetic patients with serum creatinine levels from 5.0 to 8.0 mg/dL (442-707 micromol/L) at baseline. Probabilistic sensitivity analysis was performed to evaluate the stability of the results. RESULTS: At 3 years, mean total costs per patient were estimated at 6.67 million yen (US$56,982) in the AST-120 group and 9.38 million yen (US$80,196) in the placebo group. Mean total costs were 2.72 million yen (US$23,205) lower among patients receiving AST-120. QALY per patient were 0.295 (approximately 3.5 months) greater for patients receiving AST-120 than for those receiving placebo over 3 years. The finding that treatment with AST-120 dominated placebo (i.e. was less costly and resulted in more QALY) was upheld in sensitivity analyses. CONCLUSION:
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Authors | Tomohiko Takahashi, Shelby D Reed, Kevin A Schulman |
Journal | Nephrology (Carlton, Vic.)
(Nephrology (Carlton))
Vol. 13
Issue 5
Pg. 419-27
(Oct 2008)
ISSN: 1440-1797 [Electronic] Australia |
PMID | 18518936
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Oxides
- Renal Agents
- Carbon
- AST 120
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Topics |
- Administration, Oral
- Adsorption
- Adult
- Carbon
(administration & dosage, economics)
- Cost-Benefit Analysis
- Disease Progression
- Female
- Health Care Costs
(statistics & numerical data)
- Humans
- Japan
- Kidney Failure, Chronic
(drug therapy, economics)
- Male
- Markov Chains
- Middle Aged
- Oxides
(administration & dosage, economics)
- Quality-Adjusted Life Years
- Renal Agents
(administration & dosage, economics)
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