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2015 ; 15
(3
): 271-9
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Ferric Citrate, an Iron-Based Phosphate Binder, Reduces Health Care Costs in
Patients on Dialysis Based on Randomized Clinical Trial Data
#MMPMID26239948
Rodby RA
; Umanath K
; Niecestro R
; Bond TC
; Sika M
; Lewis J
; Dwyer JP
Drugs R D
2015[Sep]; 15
(3
): 271-9
PMID26239948
show ga
BACKGROUND: Patients with end-stage renal disease (ESRD) require phosphate
binders for hyperphosphatemia and erythropoiesis-stimulating agents (ESAs) and
intravenous (i.v.) iron for anemia. Ferric citrate (FC) is a novel, iron-based
phosphate binder that increases iron stores and decreases i.v. iron and ESA usage
while maintaining hemoglobin levels, and may decrease the cost of ESRD care. The
study objectives were to (1) quantify differences in ESA and i.v. iron usage
among ESRD patients receiving FC compared with active control (AC) (sevelamer
carbonate and/or calcium acetate) on the basis of data from a 52-week phase III
clinical trial and (2) standardize trial data to the general United States (US)
ESRD population and calculate the potential impact of FC on ESRD
cost/patient/year in the USA. STUDY DESIGN: The study was a randomized,
controlled clinical trial. SETTING AND POPULATION: A total of 441 adult subjects
with ESRD who received FC or AC for 52 weeks were included. MODEL, PERSPECTIVE,
AND TIMELINE: Differences in ESA and i.v. iron usage between the treatment groups
were modeled over time using generalized linear mixed models and zero-inflated
Poisson models. Trends were modeled via logarithmic curves, and utilization
patterns were applied to the general dialysis population to estimate expected
resource savings. OUTCOMES: Study outcomes were costs saved/patient/year using FC
versus AC (US dollars). RESULTS: Our model suggests an annual decrease of 129,106
U of ESAs and 1960 mg of i.v. iron per patient in the second year after a switch
from AC to FC. Applying 2013 Medicare pricing, this would save $1585 in ESAs and
$516 in i.v. iron: a total of $2101/patient/year; these savings would be expected
to double for managed care plans. LIMITATIONS: The projections were made on 1
year of trial data. CONCLUSIONS: Phosphate binding with FC reduces i.v. iron and
ESA usage. Given the high cost burden of ESRD, our model demonstrates significant
potential cost savings. TRIAL REGISTRATION: ClinicalTrials.gov (NCT01191255)
http://clinicaltrials.gov/ct2/show/NCT01191255 .
|*Drug Costs
[MESH]
|Female
[MESH]
|Ferric Compounds/*economics/*therapeutic use
[MESH]