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Evaluation of the cost-utility of phosphate binders as a treatment option for hyperphosphatemia in chronic kidney disease patients: a systematic review and meta-analysis of the economic evaluations

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dc.contributor.authorKamolpat Chaiyakittisoponen_US
dc.contributor.authorOraluck Pattanaprateepen_US
dc.contributor.authorNarisa Ruenroengbunen_US
dc.contributor.authorTunlanut Sapankaewen_US
dc.contributor.authorAtiporn Ingsathiten_US
dc.contributor.authorGareth J. Mckayen_US
dc.contributor.authorJohn Attiaen_US
dc.contributor.authorAmmarin Thakkinstianen_US
dc.contributor.otherRamathibodi Hospitalen_US
dc.contributor.otherSchool of Medicine and Public Healthen_US
dc.contributor.otherSilpakorn Universityen_US
dc.contributor.otherSchool of Medicine, Dentistry and Biomedical Sciencesen_US
dc.date.accessioned2022-08-04T08:32:51Z
dc.date.available2022-08-04T08:32:51Z
dc.date.issued2021-06-01en_US
dc.description.abstractBackground: Uncontrolled hyperphosphatemia in chronic kidney disease (CKD) patients commonly results in vascular calcification leading to increased risk of cardiovascular disease. Phosphate binders (PBs) are used for hyperphosphatemia and can be calcium-based (CBPBs) or non-calcium-based (NCBPBs), the latter being more expensive than CBPBs. In this study, we used meta-analysis approaches to assess the cost-utility of PBs for hyperphosphatemia in CKD patients. Methods: Relevant studies published prior to June 2019 were identified from PubMed, Scopus, the Cochrane Library, the National Health Service Economic Evaluation Database, and the Cost-Effectiveness Analysis Registry. Studies were eligible if they included CKD patients with hyperphosphatemia, compared any PBs and reported economic outcomes. Meta-analysis was applied to pool incremental net benefit (INB) across studies stratified by country income. Results: A total of 25 studies encompassing 32 comparisons were eligible. Lanthanum carbonate, a NCBPB, was a more cost-effective option than CBPBs in high-income countries (HICs), with a pooled INB of $3984.4 (599.5–7369.4), especially in pre-dialysis patients and used as a second-line option with INBs of $4860.2 (641.5–9078.8), $4011.0 (533.7–7488.3), respectively. Sevelamer, also a NCBPB, was not more cost-effective as a first-line option compared to CBPBs with a pooled INB of $6045.8 (− 23,453.0 to 35,522.6) and $34,168.9 (− 638.0 to 68,975.7) in HICs and upper middle-income countries, respectively. Conclusions: Lanthanum carbonate was significantly more cost-effective than CBPBs as a second-line option for hyperphosphatemia in pre-dialysis patients in HICs. However, the use of sevelamer is not more cost-effective as a first-line option compared to CBPBs.en_US
dc.identifier.citationEuropean Journal of Health Economics. Vol.22, No.4 (2021), 571-584en_US
dc.identifier.doi10.1007/s10198-021-01275-3en_US
dc.identifier.issn16187601en_US
dc.identifier.issn16187598en_US
dc.identifier.other2-s2.0-85102318077en_US
dc.identifier.urihttps://hdl.handle.net/20.500.14594/76877
dc.rightsMahidol Universityen_US
dc.rights.holderSCOPUSen_US
dc.source.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85102318077&origin=inwarden_US
dc.subjectEconomics, Econometrics and Financeen_US
dc.subjectMedicineen_US
dc.titleEvaluation of the cost-utility of phosphate binders as a treatment option for hyperphosphatemia in chronic kidney disease patients: a systematic review and meta-analysis of the economic evaluationsen_US
dc.typeArticleen_US
dspace.entity.typePublication
mu.datasource.scopushttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85102318077&origin=inwarden_US
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