Healthcare utilization and expenditures associated with hyperkalemia management: a retrospective study of Medicare Advantage patients

Desai, Nihar R.; Alvarez, Paula J; Golestaneh, Ladan; Woods, Steven D.; Coca, Steven G.; Rowan, Christopher G.

doi:10.1080/13696998.2021.1965389

Cited by 6 publications

(8 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A similar reduction in all-cause medical costs with long-term anti-hyperkalemia therapy was also reported in an earlier, US-based, real-world insurance claims database study of long-term treatment with patiromer. 19 In this matched cohort study, 6 months of continuous patiromer exposure was associated with a significant 19% reduction in all-cause medical costs ($5212.00 per patient) compared with no oral anti-hyperkalemia therapy ( P <0.05). 19 …”

Section: Discussionmentioning

confidence: 78%

“…A retrospective study demonstrated a 19% reduction in the rate of spending for all-cause medical costs among patients on patiromer therapy compared with those who did not receive any oral anti-hyperkalemia therapy, with a cost reduction of 34% in patients with inpatient or emergency department (ED) visits. 19 These reductions offset the increase in all-cause outpatient pharmacy costs in this study. 19 In the non-comparative, real-world RECOGNIZE I study in patients with hyperkalemia who received SZC treatment in the outpatient setting, the proportions of patients with hyperkalemia-related and all-cause inpatient hospitalizations were significantly reduced among patients who received long-term (>90 days) versus short-term (≤90 days) SZC therapy.…”

Section: Introductionmentioning

confidence: 73%

“… 19 These reductions offset the increase in all-cause outpatient pharmacy costs in this study. 19 In the non-comparative, real-world RECOGNIZE I study in patients with hyperkalemia who received SZC treatment in the outpatient setting, the proportions of patients with hyperkalemia-related and all-cause inpatient hospitalizations were significantly reduced among patients who received long-term (>90 days) versus short-term (≤90 days) SZC therapy. 20 This suggests that long-term SZC therapy may also be associated with reduced medical costs in patients with hyperkalemia, although this was not analyzed in the RECOGNIZE I study.…”

Section: Introductionmentioning

confidence: 73%

See 2 more Smart Citations

Medical Costs in Patients with Hyperkalemia on Long-Term Sodium Zirconium Cyclosilicate Therapy: The RECOGNIZE II Study

Agiro,

Dwyer,

Oluwatosin

et al. 2023

CEOR

View full text Add to dashboard Cite

Purpose Hyperkalemia, defined as abnormally high serum potassium levels of ≥5.1 mmol/L, is associated with increased medical costs. This real-world study evaluated the impact of long-term sodium zirconium cyclosilicate (SZC) therapy on medical costs in patients with hyperkalemia. Patients and Methods This retrospective, comparative study used claims data from IQVIA PharMetrics ® Plus. Patients aged ≥18 years with hyperkalemia who had outpatient SZC fills (>3-month supply over 6 months) between July 2019 and December 2021 and continuous insurance coverage 6 months before and 6 months after the first SZC fill were included. These patients (SZC cohort) were 1:1 exact- and propensity score-matched on baseline variables with patients with hyperkalemia who did not receive SZC (non-SZC cohort). The primary endpoint was hyperkalemia-related medical costs to payers over 6 months. Results Each cohort included 661 matched patients. Mean per-patient hyperkalemia-related medical costs were reduced by 49.5% ($3728.47) for the SZC versus non-SZC cohort ($3798.04 vs $7526.51; P <0.001), whereas mean all-cause medical costs were reduced by 21.0% ($5492.20; $20,722.23 vs $26,214.43; P <0.01). A 39.8% ($3621.03) increase in all-cause pharmacy costs ($12,727.20 vs $9106.17; P <0.01) was offset by the medical cost savings. Conclusion This study demonstrated that long-term (>3 months) outpatient treatment with SZC was associated with medical cost savings compared with no SZC therapy.

show abstract

Section: Discussionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 73%

See 1 more Smart Citation

Medical Costs in Patients with Hyperkalemia on Long-Term Sodium Zirconium Cyclosilicate Therapy: The RECOGNIZE II Study

Agiro,

Dwyer,

Oluwatosin

et al. 2023

CEOR

View full text Add to dashboard Cite

show abstract

“…While the cost of the novel potassium binders has been invoked to limit their use, a recent propensity matched study of patients with a K + >5.0 mmol/L either receiving or not receiving patiromer found that the use of patiromer was associated with a reduction in both hospitalizations and emergency room encounters associated with a significant reduction in costs. 12…”

Section: The Use Of a Non-steroidal Mramentioning

confidence: 99%

“…While fewer episodes of HK are likely with the non‐steroidal than the steroidal MRAs, when HK is encountered or anticipated, such as in patients with an estimated glomerular filtration rate <45 ml/min/1.73 m 2 , the new potassium binders such as patiromer or sodium zirconium cyclosilicate, both of which have enabled sustained normokalaemia for at least a year in patients on an MRA, 11 can be administered. While the cost of the novel potassium binders has been invoked to limit their use, a recent propensity matched study of patients with a K + >5.0 mmol/L either receiving or not receiving patiromer found that the use of patiromer was associated with a reduction in both hospitalizations and emergency room encounters associated with a significant reduction in costs 12 …”

Section: Constructive Proposals To Increase the Use Of Mineralocortic...mentioning

confidence: 99%

A promise unfulfilled: the use of mineralocorticoid receptor antagonists in patients with heart failure and a reduced left ventricular ejection fraction

Pitt

Epstein

2022

European J of Heart Fail

View full text Add to dashboard Cite

This article refers to 'Temporal trends in initiation of mineralocorticoid receptor antagonists and risk of subsequent withdrawal in patients with heart failure: a nationwide study in Denmark from 2003-2017' by D. Zahir et al., published in this issue on pages 539-547.The steroidal mineralocorticoid receptor antagonists (MRAs) reduce mortality and hospitalizations for heart failure (HHF) in patients with heart failure and a reduced ejection fraction (HFrEF). Their incorporation into US and European guidelines as a class I indication for HFrEF held the promise for a substantial reduction in cardiovascular mortality, HHFs, and consequentially health care costs. It is therefore discouraging to observe that despite a class I indication in guidelines, over several years their use remains suboptimal in comparison to the other major guideline-recommended therapies for HFrEF.In this issue of the Journal, Zahir et al. 1 report upon the temporal trends in initiation and subsequent withdrawal of an MRA from a nationwide study of 51 512 patients with HFrEF in Denmark from 2003 to 2017. They found that only 40% of patients initiated an MRA within 6 months of their heart failure (HF) diagnosis. Furthermore, the use of an MRA did not increase significantly over the past decade. In those in whom an MRA was initiated, 49% of patients discontinued them and only 40% of these patients restarted them. The suboptimal use of MRAs in patients with HFrEF in Denmark 1 is unfortunately not unique. The US Get With the Guidelines Heart Failure Registry (GWTG-HF) 2 also found that the use of MRAs in patients with HFrEF was suboptimal, even in patients with normal renal function in whom the risk of inducing hyperkalaemia (HK) is minimal. In view of the widespread underutilization of MRAs and their poor persistence in patients with HFrEF 1,2 despite evidence of their benefit and repeated recommendations in guidelines, it is highly unlikely that further reemphasis and dissemination of guidelines will remedy the situation. Consequently, we proposeThe opinions expressed in this article are not necessarily those of the Editors of the European Journal of Heart Failure or of the European Society of Cardiology.

show abstract

Impact on hospitalizations of long-term versus short-term therapy with sodium zirconium cyclosilicate during routine outpatient care of patients with hyperkalemia: the recognize I study

Pollack

Agiro

et al. 2022

Expert Review of Pharmacoeconomics & Outcomes Research

View full text Add to dashboard Cite

Healthcare utilization and expenditures associated with hyperkalemia management: a retrospective study of Medicare Advantage patients

Cited by 6 publications

References 33 publications

Medical Costs in Patients with Hyperkalemia on Long-Term Sodium Zirconium Cyclosilicate Therapy: The RECOGNIZE II Study

Medical Costs in Patients with Hyperkalemia on Long-Term Sodium Zirconium Cyclosilicate Therapy: The RECOGNIZE II Study

A promise unfulfilled: the use of mineralocorticoid receptor antagonists in patients with heart failure and a reduced left ventricular ejection fraction

Impact on hospitalizations of long-term versus short-term therapy with sodium zirconium cyclosilicate during routine outpatient care of patients with hyperkalemia: the recognize I study

Contact Info

Product

Resources

About