title: A pharmacoeconomic analysis of phosphate binders cost-effectiveness in the RISCAVID study.
abstract: BACKGROUND
  A pharmacoeconomic analysis of the RISCAVID database aimed at assessing the cost effectiveness of phosphate binders in preventing CV mortality and morbidity over 7 years was performed.
  
  
  METHODS
  Morbid or fatal events occurring in 750 chronic HD patients were recorded. Statistical analysis evaluated the distribution of variables and the effect of sevelamer on survival. A cost-effectiveness evaluation was performed using a probabilistic model based on a Markov chain.
  
  
  RESULTS
  Multivariate analysis showed that treatment with sevelamer was associated with a reduced stroke incidence by 52% (p = 0.04) and reduced levels of C-reactive protein (p < 0.01). Cost-effectiveness evaluation evidenced a 33% decrease in hospital-days for patients treated with sevelamer, with and without comorbidities compared to patients undergoing calcium binders treatment.
  
  
  CONCLUSIONS
  Treatment with sevelamer was associated with a reduced risk of stroke in HD patients, with a clear saving on disease-related costs for the Italian National Healthcare System.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Panichi
authors.forename: Alberto
authors.initials: A
authors.lastname: Rosati
authors.forename: Adriana
authors.initials: A
authors.lastname: Di Giorgio
authors.forename: Alessia
authors.initials: A
authors.lastname: Scatena
authors.forename: Roberto
authors.initials: R
authors.lastname: Bigazzi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Grazi
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Migliori
authors.forename: Sabrina
authors.initials: S
authors.lastname: Paoletti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Manca Rizza
authors.forename: Aldo
authors.initials: A
authors.lastname: Casani
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sgambato
authors.forename: Matteo
authors.initials: M
authors.lastname: Ruggeri
mesh_terms: D000085:Acetates / Q000627:therapeutic use; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D002119:Calcium Carbonate / Q000627:therapeutic use; D017610:Calcium Compounds / Q000627:therapeutic use; D002614:Chelating Agents / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000150:complications / Q000191:economics / Q000401:mortality / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy* / Q000191:economics / Q000401:mortality; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D010710:Phosphates / Q000378:metabolism*; D011446:Prospective Studies; D019057:Quality-Adjusted Life Years; D006435:Renal Dialysis; D000069603:Sevelamer / Q000627:therapeutic use*; D020521:Stroke / Q000150:complications / Q000191:economics / Q000401:mortality / Q000517:prevention & control*; D016019:Survival Analysis; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D000085:Acetates; D017610:Calcium Compounds; D002614:Chelating Agents; D010710:Phosphates; D014807:Vitamin D; D002097:C-Reactive Protein; D000069603:Sevelamer; D002119:Calcium Carbonate; C120662:calcium acetate