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- Title
Sevelamer Is Cost-Saving vs. Calcium Carbonate in Non-Dialysis-Dependent CKD Patients in Italy: A Patient-Level Cost-Effectiveness Analysis of the INDEPENDENT Study.
- Authors
Ruggeri, Matteo; Cipriani, Filippo; Bellasi, antonio; Russo, Domenico; Di Iorio, Biagio; Springer Healthcare Italia s.r.
- Abstract
Objectives: To conduct a cost-effectiveness analysis of sevelamer versus calcium carbonate in patients with non-dialysis-dependent CKD (NDD-CKD) from the Italian NHS perspective using patient-level data from the INDEPENDENT-CKD study. Methods: Patient-level data on all-cause mortality, dialysis inception and phosphate binder dose were obtained for all 107 sevelamer and 105 calcium carbonate patients from the INDEPENDENT-CKD study. Hospitalization and frequency of dialysis data were collected post hoc for all patients via a retrospective chart review. Phosphate binder, hospitalization, and dialysis costs were expressed in 2012 euros using hospital pharmacy, Italian diagnosis-related group and ambulatory tariffs, respectively. Total life years (LYs) and costs per treatment group were calculated for the 3-year period of the study. Bootstrapping was used to estimate confidence intervals around outcomes, costs, and cost-effectiveness and to calculate the cost-effectiveness acceptability curve. A subgroup analysis of patients who did not initiate dialysis during the INDEPENDENT-CKD study was also conducted. Results: Sevelamer was associated with 0.06 additional LYs (95% CI -0.04 to 0.16) and cost savings of EUR -5,615 (95% CI -10,066 to -1,164) per patient compared with calcium carbonate. On the basis of the bootstrap analysis, sevelamer was dominant compared to calcium carbonate in 87.1% of 10,000 bootstrap replicates. Similar results were observed in the subgroup analysis. Results were driven by a significant reduction in all-cause mortality and significantly fewer hospitalizations in the sevelamer group, which offset the higher acquisition cost for sevelamer. Conclusions: Sevelamer provides more LYs and is less costly than calcium carbonate in patients with NDD-CKD in Italy. © 2014 S. Karger AG, Basel
- Subjects
KIDNEY disease treatments; CALCIUM carbonate; COST effectiveness; STATISTICAL bootstrapping; HEMODIALYSIS; THERAPEUTICS
- Publication
Blood Purification, 2014, Vol 37, Issue 4, p316
- ISSN
0253-5068
- Publication type
Article
- DOI
10.1159/000365746