HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Health and economic consequences of sevelamer use for hyperphosphatemia in patients on hemodialysis.

AbstractOBJECTIVES:
The safety and efficacy of sevelamer hydrochloride in binding phosphate in patients with end-stage renal disease and its ability to attenuate the progression of cardiac calcification have been well documented but not the longer-term health and economic implications. Thus, a model of the predicted long-term consequences of sevelamer compared with calcium-based binders (acetate and carbonate) was developed.
METHODS:
Long-term cardiovascular implications of 1 year of treatment with phosphate binders in patients on hemodialysis are estimated based on the patient's demographics, comorbidities, and physiologic and renal parameters. The initial calcification score and expected changes over 1 year are derived using regression equations developed from the Treat-to-Goal study and translated to cardiovascular disease risk based on equations developed from a long-term cohort study. In this article, the implications of cardiovascular disease for life expectancy and medical costs are accounted for from a US payer perspective.
RESULTS:
The cardioprotective effect of sevelamer over 1 year is estimated to result in a 12% reduction in cardiovascular events compared with calcium acetate. In a population of 100 patients, the savings of 205,600 dollars accrued due to avoiding nine cardiovascular events with sevelamer, largely offset the increased binder costs, leading to a favorable cost-effectiveness ratio of about 2200 dollars per (discounted) life-year gained.
CONCLUSIONS:
Although both binders provide equivalent phosphate binding capacity, the results indicate that the advantage of 1 year of treatment with sevelamer in attenuating the progression of calcification has important clinical and economic consequences, suggesting that this provides good value for money.
AuthorsKrista F Huybrechts, J Jaime Caro, David A Wilson, Judith A O'Brien
JournalValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research (Value Health) 2005 Sep-Oct Vol. 8 Issue 5 Pg. 549-61 ISSN: 1098-3015 [Print] United States
PMID16176493 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Acetates
  • Calcium Compounds
  • Cardiotonic Agents
  • Epoxy Compounds
  • Phosphates
  • Polyamines
  • Polyethylenes
  • Sevelamer
  • calcium acetate
Topics
  • Acetates (economics, pharmacology, therapeutic use)
  • Adult
  • Aged
  • Calcinosis (economics, etiology, prevention & control)
  • Calcium Compounds
  • Cardiomyopathies (economics, etiology, prevention & control)
  • Cardiotonic Agents (economics, pharmacology, therapeutic use)
  • Cost-Benefit Analysis
  • Direct Service Costs
  • Epoxy Compounds (economics, pharmacology, therapeutic use)
  • Female
  • Humans
  • Kidney Failure, Chronic (complications, therapy)
  • Male
  • Middle Aged
  • Phosphates (blood)
  • Phosphorus Metabolism Disorders (drug therapy, physiopathology)
  • Polyamines
  • Polyethylenes (economics, pharmacology, therapeutic use)
  • Proportional Hazards Models
  • Quality-Adjusted Life Years
  • Randomized Controlled Trials as Topic
  • Regression Analysis
  • Renal Dialysis
  • Sevelamer
  • Time
  • United States

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: