scholarly journals Paricalcitol versus Calcitriol + Cinacalcet for the Treatment of Secondary Hyperparathyroidism in Chronic Kidney Disease in China: A Cost-Effectiveness Analysis

2021 ◽  
Vol 9 ◽  
Author(s):  
Zhuolin Zhang ◽  
Lele Cai ◽  
Hong Wu ◽  
Xinglu Xu ◽  
Wenqing Fang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Life Years ◽  
Ckd Stage ◽  
Hospitalization Costs

Background: Chronic Kidney Disease (CKD) is a global chronic disease with increasing prevalence in recent years, particularly CKD accompanied by Secondary Hyperparathyroidism (SHPT) leads to reduced quality of life, increased mortality, a considerable economic burden for patients and society. The aim of this study was to investigate the cost-effectiveness analysis of paricalcitol vs. calcitriol + cinacalcet for CKD patients with SHPT in China in 2020.Methods: A Markov model was conducted employing data derived from published literature, clinical trials, official sources, and tertiary public hospital data in China, based on a 10-year horizon from the perspective of the healthcare system. Calcitriol + Cinacalcet was used as the reference group. CKD stage 5 (CKD-5) dialysis patients suffering from SHPT were included in the study. Effectiveness was measured in quality-adjusted life years (QALYs). The discount rate (5%) was applied to costs and effectiveness. Sensitivity analysis was performed to confirm the robustness of the findings.Results: The base case analysis demonstrated that Patients treated with paricalcitol could gain an increase in utility (0.183 QALYs) and require fewer expenditures (6925.612 yuan). One-way sensitivity analysis was performed to showed that impact factors were the price of cinacalcet, the hospitalization costs of patients with paricalcitol and calcitriol, the costs and utilities of hemodialysis and the costs of calcitriol, the costs of paricalcitol regardless of period. Probabilistic simulation analysis displayed when willingness-to-pay was ¥217113, the probability that Paricalcitol was dominant is 96.20%.Conclusion: The results showed that paricalcitol administrated to treat patients diagnosed with Secondary hyperparathyroidism in Chronic Kidney Disease, compared to calcitriol and cinacalcet, might be dominant in China.

scholarly journals Cost-Effectiveness Analysis of Screening Chronic Kidney Disease in Iran

2019 ◽  
Author(s):  
Hamid Ravaghi ◽  
Mahdi Ebrahimnia ◽  
Ali Farzaneh ◽  
Zohreh Rostami ◽  
Mohammad Hasan Hashemi Madani
Keyword(s):  
Chronic Kidney Disease ◽  
Cost Effectiveness ◽  
Kidney Disease ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis

Cost-Effectiveness Analysis of Therapies for Chronic Kidney Disease Patients on Dialysis

2012 ◽  
Vol 30 (11) ◽  
pp. 981-989 ◽  
Author(s):  
Daniel T. Grima ◽  
Lisa M. Bernard ◽  
Elizabeth S. Dunn ◽  
Philip A. McFarlane ◽  
David C. Mendelssohn
Keyword(s):  
Chronic Kidney Disease ◽  
Cost Effectiveness ◽  
Kidney Disease ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis

scholarly journals Comparing Prednisone and Methotrexate to Off-label Biologic Infliximab for Management of Ocular Uveitis: A Cost-minimization Analysis

10.36469/9895 ◽  
2015 ◽  
Vol 2 (2) ◽  
pp. 131-146
Author(s):  
William V. Padula ◽  
Miguel Cordero-Coma ◽  
Taygan Yilmaz ◽  
William V. Padula ◽  
Michéal J. Gallagher ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
The United States ◽  
Posterior Uveitis ◽  
Cost Effectiveness Analysis ◽  
Sensitivity Analyses ◽  
Off Label ◽  
Effectiveness Analysis ◽  
Life Years ◽  
Successful Recovery

Background: Approximately 3.75% of cases of blindness in the United States are caused by uveitis. Incurred clinical costs and lost productivity related to vision loss in these cases totals $3.58 billion annually. Objective: To evaluate whether infliximab, a modern off-label biologic, is cost-effective for treating posterior uveitis and panuveitis compared to current standards of care, methotrexate and prednisone. Methods: A cost-effectiveness analysis using a Markov model to simulate a patient cohort with posterior uveitis or panuveitis. The model followed patients’ therapy from the onset of posterior uveitis or panuveitis using the U.S. societal perspective. The lifetime model simulated health states that could lead to successful reversal of uveitis with standard or intensified treatment with prednisone, methotrexate, or infliximab. Probabilities, health utilities, and costs were included in the model based on findings from the literature. We conducted univariate sensitivity analyses and a Bayesian multivariate probablistic sensitivity analysis to estimate uncertainty in results. Outcomes were measured in terms of costs ($US, 2010) and effects (qualityadjusted life years; QALYs) discounted at 3% per year were estimated for each simulated treatment. An incremental cost-effectiveness ratio (ICER) for pairwise results was interpretted assuming a predetermined willingness-to-pay threshold of $100,000/QALY. Results: Average lifetime costs and QALYs for each drug were ($306.95; 15.80 QALYs) for prednisone, methotrexate ($36,232.24; 16.21 QALYs), and inflixmab ($74,762.63; 15.04 QALYs). Methotrexate was on average compared to prednisone, with an ICER of $86,901.16/QALY. Prednisone and methotrexate dominated infliximab. Sensitivity analyses suggested that the model was most sensitive to the utility for successful recovery from uveitis. The probabilistic sensitivity analysis returned results similar to the base case. Conclusion: This cost-effectiveness analysis suggests that despite advances in the use of biologics for treating sight-threatening posterior uveitis and panuveitis, infliximab had lower effectiveness and higher costs compared to both prednisone and methotrexate. As compared to prednisone, methotrexate was associated with increased costs and QALYs and was found to be a good value. Clinical trials of infliximab in the uveitis population are needed to reduce the uncertain estimates of inflixmab treatment success and the drug’s cost-effectiveness.

PHARMACOECONOMICS OF ORAL PARICALCITOL THERAPY IN PATIENTS WITH A CHRONIC KIDNEY DISEASE AND SECONDARY HYPERPARATHYROIDISM

2019 ◽  
Vol 23 (1) ◽  
pp. 67-72
Author(s):  
A. V. Rudakova
Keyword(s):  
Chronic Kidney Disease ◽  
Cost Effectiveness ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Impact Analysis ◽  
Budget Impact ◽  
Budget Impact Analysis ◽  
Early Stages ◽  
Ckd Stage ◽  
The Cost

Selective vitamin D receptors agonist paricalcitol can increase probability of proteinuria reduction at patients with the chronic kidney disease (CKD) and secondary hyperparathyroid-ism. THE AIM of this study was to determine the cost effectiveness of oral paricalcitol in patients with a CKD and secondary hyperparathyroidism and to carry out the budget impact analysis to understand the potential financial effect of introducing this drug in a health plan. MATERIALS AND METHODS. Assessment was carried out from a health care payer per-spective with use of the 5-year temporary horizon. Markov modeling on the basis of results of double blind trials at whom the efficacy of a paricalcitol at patients with hyperparathyroidism was estimated is carried out. The analysis is carried out taking into account tariffs of compulsory health insurances across St. Petersburg for 2018. Cost of paricalcitol corresponded to the price of registration including VAT for 2018 and 10% of a trade extra charge (5061.27 rub for 28 caps. on 1 mcg). During cost-effectiveness assessment clinical and economic outcomes were discounted at 3,5% a year. The budget impact analysis was carried out without discount-ing. RESULTS. Purpose of an oral paricalcitol to patients with CKD stage 3-4 and secondary hyperparathyroidism allows to increase time before transition to dialysis and life expectancy on average for 0,049-0,134 and for 0,033-0,144 year, respectively (when calculating without dis-counting). The cost effectiveness of an oral paricalcitol is higher at early stages of a nephropathy – 1,377 million rubles / year without dialysis gained, 1,408 million rubles / life year gained and 1,647 million rubles / QALY. At the same time paricalcitol therapy of patients with early stages of a nephropathy demands increase of cumulative expenses in 5 years by 2,24 times. CONCLUSIONS. Oral paricalcitol therapy in patients with a CKD and secondary hyperparathyroidism, according to results of modeling, allows to postpone transition of patients to dial-ysis and, taking into account the made assumptions, can be considered in patients with early stages of a nephropathy as economically acceptable intervention.

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