Economic Evaluation of Sevelamer versus Calcium-based Binders in Treating Hyperphosphatemia among Patients with End-stage Renal Disease in China

Evaluation of the cost-utility of phosphate binders as a treatment option for hyperphosphatemia in chronic kidney disease patients: a systematic review and meta-analysis of the economic evaluations

“…Among them, 20 studies [ 47 – 66 ] (number comparisons ( n ) = 26) and 7 studies [ 59 , 60 , 67 – 71 ] ( n = 9) provided data on CUA in cost/QALYs and CEA in cost/LYs, respectively. Of the CUA studies, 18 [ 49 – 66 ] and 2 [ 47 , 48 ] were conducted in HICs and UMICs, respectively. Four comparisons of PBs were included: sevelamer versus CBPBs ( N = 9 for HICs [ 49 – 57 ] and N = 2 for UMICs [ 47 , 48 ]), lanthanum carbonate versus CBPBs ( N = 7 for HICs [ 49 , 57 – 62 ]), lanthanum carbonate versus sevelamer ( N = 3 for HICs [ 49 , 63 , 64 ]), and sucroferric oxyhydroxide versus sevelamer ( N = 2 for HICs [ 65 , 66 ]).…”

“…Of the CUA studies, 18 [ 49 – 66 ] and 2 [ 47 , 48 ] were conducted in HICs and UMICs, respectively. Four comparisons of PBs were included: sevelamer versus CBPBs ( N = 9 for HICs [ 49 – 57 ] and N = 2 for UMICs [ 47 , 48 ]), lanthanum carbonate versus CBPBs ( N = 7 for HICs [ 49 , 57 – 62 ]), lanthanum carbonate versus sevelamer ( N = 3 for HICs [ 49 , 63 , 64 ]), and sucroferric oxyhydroxide versus sevelamer ( N = 2 for HICs [ 65 , 66 ]). All CEA studies were from HICs with sevelamer versus CBPBs ( N = 5 [ 67 – 71 ]) and lanthanum carbonate versus CBPBs ( N = 2 [ 59 , 60 ]).…”

“…Most studies used Markov models ( N = 18 [ 47 , 48 , 50 – 60 , 63 – 67 ]) and were evaluated over a patient’s lifetime ( N = 21 [ 47 – 49 , 51 – 62 , 64 – 69 ]). Nineteen [ 48 – 53 , 60 – 70 ] and eight studies [ 47 , 54 – 59 , 71 ] focused on dialysis and pre-dialysis patients, respectively. The majority of studies accounted for dialysis costs in their analyses, although 9 studies failed to do so [ 48 – 50 , 63 – 66 , 68 , 69 ].…”

“…Nineteen [ 48 – 53 , 60 – 70 ] and eight studies [ 47 , 54 – 59 , 71 ] focused on dialysis and pre-dialysis patients, respectively. The majority of studies accounted for dialysis costs in their analyses, although 9 studies failed to do so [ 48 – 50 , 63 – 66 , 68 , 69 ]. All studies, with the exception of two [ 70 , 71 ], reported direct costs with discounting for both costs and outcomes.…”

“…Twenty-one of the 25 studies reported that NCBPBs were cost-effective, of which 19 [ 49 , 50 , 52 – 56 , 58 – 62 , 64 , 66 – 71 ] and two studies [ 47 , 48 ] originated from HICs and UMICs, respectively. For the 19 studies from HICs, 11 [ 50 , 52 – 56 , 67 – 71 ] concluded that sevelamer was more cost-effective than CBPBs.…”