DISEASE BURDEN AND ECONOMIC ASPECTS OF HYPERPHOSPHATEMIA AMONG PATIENTS WITH END-STAGE RENAL DISEASE IN CHINA
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 review the current disease burden and economic aspects related to hyperphosphatemia among end-stage renal disease patients in China and provide scientific evidence on economic evaluation between two new non-calcium based phosphate binders therapies, sevelamer and lanthanum, through cost-minimization analysis from the payers’ perspective in China.
Method(s):
Clinical practice, disease burden and economic aspects were reviewed in treating hyperphosphatemia in China with non-calcium based phosphate binders as new treatment alternatives. Cost minimization analysis and comparison between sevelamer and lanthanum, was further conducted based on the local unit costs, the equivalent dose ratios and survival extrapolation in published studies. Based on the equivalent dose ratio of sevelamer/lanthanum at 2.13 assessed in the cross-over direct comparison study or 2.27 in a real world observational study, the daily dose in China of sevelamer was estimated by using the average dose of lanthanum derived from an multicenter randomized controlled trial in China. Given that the unit retail prices of sevelamer and lanthanum in China, the daily drug costs were calculated respectively for sevelamer and lanthanum. The impact of daily cost difference between these two products was also extrapolated to life time horizon with an expected life year of 5.38 years derived from relevant literature.
Result(s):
The issue of hyperphosphatemia is prominent in China leading to end-stage renal disease with a prevalence of 57.4% in hemodialysis patients and 47.4% in peritoneal dialysis patients resulting in a substantial clinical and economic burden. Our cost analysis indicates that sevelamer is likely to cost less than lanthanum in the local context of China with potential savings of up to approximately RMB 38 thousands per patient over an estimated survival projection of 5.38 years for a dialysis patient with hyperphosphatemia.
Conclusion(s):
For the treatment of hyperphosphatemia in end-stage renal disease patients in China, our analysis demonstrate 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.
Study funding provided by Sanofi China.