Cost-effectiveness of paricalcitol in hemodialysis patients with secondary hyperparathyroidism
https://doi.org/10.28996/2618-9801-2018-4-378-384
Abstract
The objective of this study was to determine the cost effectiveness of intravenous paricalcitol versus non-selective vitamin D receptor agonists (VDRA) in patients with chronic kidney disease (CKD) and a secondary hyperparathyroidism, although without hypercalcemia and hyperphosphatemia in Russian Federation. Patients and methods: the analysis was carried out for hemodialysis patients with the level of serum parathyroid hormone over 300 pg/ml despite the standard therapy including restriction of phosphorus consumption and phosphate-binding agents, without hypercalcemia and hyperphosphatemia. Markov modeling on the basis of clinical trials and epidemiological data on the Russian Federation taking into account tariffs of compulsory health insurances across St. Petersburg is used. Assessment was carried out from a health care payer perspective with use of the 15-year temporary horizon. Clinical and economic outcomes were discounted at 3.5% a year. Results: according to results of modeling, paricalcitol can provide the increase in average life expectancy in comparison with non-selective VDRA for 0.683 year (without discounting). The cost effectiveness of paricalcitol, taking into account the made assumptions, will be 1820.7 thousand rubles/QALY and 1234.0 thousand rubles /LYG. The dose of a paricalcitol at therapy of this group of patients has significant effect on results of cost-effectiveness assessment. Conclusions: paricalcitol in hemodialysis patients with CKD and a secondary hyperparathyroidism without hypercalcemia and hyperphosphatemia can be considered, taking into account assumptions made during modeling, as economically acceptable for the health care system in Russia.
About the Author
A. V. Rudakova
Saint Petersburg State Chemical Pharmaceutical University
Russian Federation
Russian Federation
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Review
For citations:
Rudakova A.V. Cost-effectiveness of paricalcitol in hemodialysis patients with secondary hyperparathyroidism. Nephrology and Dialysis. 2018;20(4):378-384. (In Russ.) https://doi.org/10.28996/2618-9801-2018-4-378-384
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