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Pharmacological control of secondary hyperparathyroidism in hemodialysis subjects: a cost consequences analysis of data from the FARO study.
J Med Econ. 2012; 15(6):1110-7.JM

Abstract

BACKGROUND AND OBJECTIVES

Secondary hyperparathyroidism (SHPT) is a frequent complication of CKD with incidence, prevalence, and costs increasing worldwide. The objective of this analysis was to estimate therapy cost of SHPT in a sub-population of the FARO study.

MATERIALS AND METHODS

In the FARO study, an observational survey aimed to evaluate patterns of treatment in patients with SHPT who had undergone hemodialysis, pharmacological treatments and biochemical parameters evolution data were collected in four surveys. Patients maintaining the same treatment in all sessions were grouped by type of treatment and evaluated for costs from the Italian National Health Service perspective.

RESULTS

Four cohorts were identified: patients treated with oral (PO) calcitriol (n=182), intravenous (IV) calcitriol (n=34), IV paricalcitol (n=62), and IV paricalcitol+cinacalcet therapy (n=20); the cinacalcet monotherapy group was not analysed due to low number of patients (n=9). Parathyroid hormone (PTH) level at baseline and effectiveness of treatments in suppressing PTH level were assessed to test comparability among cohorts: calcitriol PO patients were significantly less severe than others (PTH level at baseline lower than 300 pg/ml; p<0.0001); calcitriol IV patients did not reach significant reduction in PTH level. Paricalcitol and paricalcitol+cinacalcet treatment groups results were comparable, while only the IV paricalcitol cohort's PTH level, weekly dosage, and cost decreased significantly from the first to the fourth survey (p=0.020, p=0.012, and p=0.0124, respectively). Total costs per week of treatment (including calcium-based phosphate binder and sevelamer) were significantly lower in the paricalcitol vs paricalcitol+cinacalcet cohort (p<0.001). Major limitations of this study are related to the survey design: not controlled and lack of comparability between cohorts; however, reflective of true practice patterns.

CONCLUSIONS

The IV Paricalcitol cohort had significantly lower treatment costs compared with patients treated with paricalcitol+calcimemtics (p<0.001), without a significant difference in terms of baseline severity and PTH control.

Authors+Show Affiliations

daniela_roggeri@procuresolutions.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22702445

Citation

Roggeri, Daniela Paola, et al. "Pharmacological Control of Secondary Hyperparathyroidism in Hemodialysis Subjects: a Cost Consequences Analysis of Data From the FARO Study." Journal of Medical Economics, vol. 15, no. 6, 2012, pp. 1110-7.
Roggeri DP, Mazzaferro S, Brancaccio D, et al. Pharmacological control of secondary hyperparathyroidism in hemodialysis subjects: a cost consequences analysis of data from the FARO study. J Med Econ. 2012;15(6):1110-7.
Roggeri, D. P., Mazzaferro, S., Brancaccio, D., Cannella, G., Messa, P., Di Luca, M., Morosetti, M., Costanzo, A. M., di Luzio Paparatti, U., Cornago, D., & Cozzolino, M. (2012). Pharmacological control of secondary hyperparathyroidism in hemodialysis subjects: a cost consequences analysis of data from the FARO study. Journal of Medical Economics, 15(6), 1110-7. https://doi.org/10.3111/13696998.2012.703632
Roggeri DP, et al. Pharmacological Control of Secondary Hyperparathyroidism in Hemodialysis Subjects: a Cost Consequences Analysis of Data From the FARO Study. J Med Econ. 2012;15(6):1110-7. PubMed PMID: 22702445.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pharmacological control of secondary hyperparathyroidism in hemodialysis subjects: a cost consequences analysis of data from the FARO study. AU - Roggeri,Daniela Paola, AU - Mazzaferro,Sandro, AU - Brancaccio,Diego, AU - Cannella,Giuseppe, AU - Messa,Piergiorgio, AU - Di Luca,Marina, AU - Morosetti,Massimo, AU - Costanzo,Anna Maria, AU - di Luzio Paparatti,Umberto, AU - Cornago,Dante, AU - Cozzolino,Mario, AU - ,, Y1 - 2012/07/06/ PY - 2012/6/19/entrez PY - 2012/6/19/pubmed PY - 2013/4/30/medline SP - 1110 EP - 7 JF - Journal of medical economics JO - J Med Econ VL - 15 IS - 6 N2 - BACKGROUND AND OBJECTIVES: Secondary hyperparathyroidism (SHPT) is a frequent complication of CKD with incidence, prevalence, and costs increasing worldwide. The objective of this analysis was to estimate therapy cost of SHPT in a sub-population of the FARO study. MATERIALS AND METHODS: In the FARO study, an observational survey aimed to evaluate patterns of treatment in patients with SHPT who had undergone hemodialysis, pharmacological treatments and biochemical parameters evolution data were collected in four surveys. Patients maintaining the same treatment in all sessions were grouped by type of treatment and evaluated for costs from the Italian National Health Service perspective. RESULTS: Four cohorts were identified: patients treated with oral (PO) calcitriol (n=182), intravenous (IV) calcitriol (n=34), IV paricalcitol (n=62), and IV paricalcitol+cinacalcet therapy (n=20); the cinacalcet monotherapy group was not analysed due to low number of patients (n=9). Parathyroid hormone (PTH) level at baseline and effectiveness of treatments in suppressing PTH level were assessed to test comparability among cohorts: calcitriol PO patients were significantly less severe than others (PTH level at baseline lower than 300 pg/ml; p<0.0001); calcitriol IV patients did not reach significant reduction in PTH level. Paricalcitol and paricalcitol+cinacalcet treatment groups results were comparable, while only the IV paricalcitol cohort's PTH level, weekly dosage, and cost decreased significantly from the first to the fourth survey (p=0.020, p=0.012, and p=0.0124, respectively). Total costs per week of treatment (including calcium-based phosphate binder and sevelamer) were significantly lower in the paricalcitol vs paricalcitol+cinacalcet cohort (p<0.001). Major limitations of this study are related to the survey design: not controlled and lack of comparability between cohorts; however, reflective of true practice patterns. CONCLUSIONS: The IV Paricalcitol cohort had significantly lower treatment costs compared with patients treated with paricalcitol+calcimemtics (p<0.001), without a significant difference in terms of baseline severity and PTH control. SN - 1941-837X UR - https://www.unboundmedicine.com/medline/citation/22702445/Pharmacological_control_of_secondary_hyperparathyroidism_in_hemodialysis_subjects:_a_cost_consequences_analysis_of_data_from_the_FARO_study_ L2 - https://www.tandfonline.com/doi/full/10.3111/13696998.2012.703632 DB - PRIME DP - Unbound Medicine ER -