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- Title
Cost-effectiveness of the oral adsorbent AST-120 versus placebo for chronic kidney disease.
- Authors
TAKAHASHI, TOMOHIKO; REED, SHELBY D; SCHULMAN, KEVIN A
- 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 µmol/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 (US$56 982) in the AST-120 group and ¥9.38 million (US$80 196) in the placebo group. Mean total costs were ¥2.72 million (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: The use of AST-120 in patients with advanced chronic kidney disease may help to slow the rate of growth in expenditures for kidney disease.
- Subjects
JAPAN; CHRONIC kidney failure; KIDNEY diseases; BLOOD filtration; ORAL drug administration; MEDICAL care costs
- Publication
Nephrology, 2008, Vol 13, Issue 5, p419
- ISSN
1320-5358
- Publication type
Article
- DOI
10.1111/j.1440-1797.2008.00960.x