Health technology appraisal of sevelamer and calcium phosphate binders in hemodialysis patient with end stage renal disease (ESRD).
Modelling of published clinical outcomes was used for pharmacoeconomic evaluation of two strategies of treatment.
Sevelamer is more expensive than calcium carbonate but it reduces a risk of cardiovascular events (acute myocardial infarction, stroke, angina pectoris, arrhythmia) compared with calcium salts. Sevelamer strategy was associated with the higher annual costs for the drug treatment by 64% (150 710,31 and 91 824,02 RUR/patient, respectively) but the lower annual costs for the treatment of cardiovascular complications by 86% (60 286,76 and 172 190,76 RUR/ patient, respectively) compared with calcium phosphate binders. Therefore, total annual costs for one patient in the calcium salt group were 8% higher vs sevelamer group (1 128 094,80 vs 1 046 961,07 RUR). Additional costs for substitution of calcium for sevelamer did not exceed a willingness to pay from the Russian society point of view.
Sevelamer can be recommended for reimbursement in hemodialysis patients.