Health-economic comparison of paricalcitol, calcitriol and alfacalcidol for the treatment of secondary hyperparathyroidism during haemodialysis.
This study evaluated the health-economic consequences of use of intravenous paricalcitol (Zemplar), oral calcitriol or oral and intravenous alfacalcidol for the treatment of patients with secondary hyperparathyroidism, focusing on a third-party payer perspective through inclusion of medication and hospital costs, survival rates and utilities. Cost values were based on German treatment recommendations and prices. Reference values for survival rates and utilities were based on the results of a MEDLINE search. The analysis showed a clear advantage for intravenous paricalcitol with respect to costs, effectiveness and utilities compared with treatment with oral calcitriol or intravenous alfacalcidol. Since the results were very cost sensitive with respect to selected diagnosis-related groups (DRGs) for kidney disease with dialysis, a sensitivity analysis was performed. This demonstrated first-order dominance of intravenous paricalcitol for a wide range of hospitalisation costs. In conclusion, this analysis suggested a clear benefit from the perspective of a third-party payer for intravenous paricalcitol compared with oral calcitriol and intravenous alfacalcidol in the treatment of patients with secondary hyperparathyroidism.
Rosery
Hubertus
H
Analytica International GmbH, Lörrach, Germany. hrosery@de.analyticaintl.com
Bergemann
Rito
R
Marx
Steven E
SE
Boehnke
Axel
A
Melnick
Joel
J
Sterz
Raimund
R
Williams
Laura
L
D002117:Calcitriol / Q000191:economics / Q000627:therapeutic use*; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D004872:Ergocalciferols / Q000191:economics / Q000627:therapeutic use*; D017048:Health Care Costs; D006801:Humans; D006887:Hydroxycholecalciferols / Q000191:economics / Q000627:therapeutic use*; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy*; D019057:Quality-Adjusted Life Years; D006435:Renal Dialysis / Q000009:adverse effects*; D015996:Survival Rate
D004872:Ergocalciferols; D006887:Hydroxycholecalciferols; C084656:paricalcitol; D002117:Calcitriol; C008088:alfacalcidol