Cost-minimization Analysis between Sevelamer and Lanthanum in Treating Hyperphosphatemia among Patients with End-stage Renal Disease in China

Li Yang, Seng Chuen Tan, Can C

Abstract

Background: Hyperphosphatemia is a great challenge for all countries, which contributes to vascular calcification and is associated with all-cause mortality for patients with chronic kidney disease. There are evidences showing the better efficacy in mortality, hospitalization of non-calcium based phosphate binders versus calcium-based phosphate binders. This study aims to provide scientific evidence on economic evaluation between two new non-calcium based phosphate binders, sevelamer and lanthanum, among end-stage renal disease patients in China through cost-minimization analysis from a patient perspective. Methods: A cost-minimization analysis comparing sevelamer and lanthanum was conducted based on a review of current clinical evidence in treating hyperphosphatemia in China. The local unit costs, the equivalent dose ratios, estimated daily doses and survival extrapolation in published studies were applied. Results: Our cost analysis indicates that sevelamer is likely to cost less than lanthanum in the local  ontext of China with potential savings of up to approximately RMB 38,000 per patient over an estimated survival projection of 5.38 years for a dialysis patient with hyperphosphatemia. Conclusion: For the treatment of hyperphosphatemia in end-stage renal disease patients in China, our analysis demonstrates sevelamer being likely a cost-saving option compared to lanthanum, both non-calcium based phosphate binders that provide more efficacious alternatives than calcium-based phosphate binders. 

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