Economic Evaluation of Sodium Zirconium Cyclosilicate Lokelma for Treating Hyperkalemia in Patients With Heart Failure and/or Chronic Kidney Disease in Egypt
Author(s)
Asmaa Saad Abourawash, BSc1, Ahmed Mohammed Seyam, BSc2, Hossam Elhusseini3, Mahmoud L. Yousif4, Noura Maher Mohamed, BSc, PharmD5, Rania Abdelaziz, MD6, Wael Omran, BSc7, Fatma Mamish, BSc8, Noha Nosir, BSc7, Moustafa Gamal, BSc9, Mariana Nabil, BSc10.
1Egyptian drug authority, cairo, Egypt, 2Universal health Insurance Authority, Cairo, Egypt, 3Egypt, 4Cairo, Egypt, 5Egyptian Universal health insurance, Shibin El Kom, Egypt, 6Egyptian Universal Health Insurance, Cairo, Egypt, 7Egyptian Health Authority, Cairo, Egypt, 8The Egyptian Authority for Unified Procurement (UPA), Cairo, Egypt, 9Egyptian Unified Procurement Authority, Cairo, Egypt, 10El Galaa military hospital, Cairo, Egypt.
1Egyptian drug authority, cairo, Egypt, 2Universal health Insurance Authority, Cairo, Egypt, 3Egypt, 4Cairo, Egypt, 5Egyptian Universal health insurance, Shibin El Kom, Egypt, 6Egyptian Universal Health Insurance, Cairo, Egypt, 7Egyptian Health Authority, Cairo, Egypt, 8The Egyptian Authority for Unified Procurement (UPA), Cairo, Egypt, 9Egyptian Unified Procurement Authority, Cairo, Egypt, 10El Galaa military hospital, Cairo, Egypt.
OBJECTIVES: Compare the cost-effectiveness of Sodium Zirconium Cyclosilicate (SZC) versus the standard of care (short-term use of sodium polystyrene sulfonate [SPS], dietary modification, and RAASi down-titration) in the treatment of hyperkalaemia in patients with heart failure and/or chronic kidney disease from the Egyptian national payer perspective.
METHODS: An individual patient simulation cost utility model was adapted to assess the costs and consequences over a time horizon of 20 years. SZC was evaluated against standard of care. Patients could experience acute hyperkalaemia, major adverse cardiovascular events (MACE), hospitalization, or modifications in RAASi therapy based on disease stage or class. K+ coefficients. The main outcomes were total costs, quality-adjusted life years (QALYs), and incremental cost- effectiveness ratio (ICER). Resource utilization in disease health states and acute events managements is gathered from the literature and validated from local clinical experts. Drug costs were collected from UPA while medical resources costs were estimated from the national payer perspective for the 2025 financial year. Both costs and outcomes were discounted at an annual rate of 3.5%,
RESULTS: SZC demonstrated high cost-effectiveness in both heart failure (HF) patients and those with concomitant CKD and HF. In HF patients, SZC yielded an incremental QALY gain of 0.976 QALYs with an incremental total cost of 193,121 EGP ($3,862), resulting in an ICER of 197,951EGP ($3,959)/QALY. For patients with both CKD and HF, SZC provided an incremental QALY gain of 0.736 QALYs at an incremental total cost of 181,349 EGP ($3,627), leading to an ICER of 246,415 EGP ($4,928)/QALY. Both ICERs fall below the WTP threshold of 427,866 EGP ($8,557) per QALY
CONCLUSIONS: For CKD and HF patients with hyperkalaemia, SZC offers a cost-effective option from the Egyptian national payer perspective. Over a 20-year horizon, improved survival and reduced HK-related hospitalizations offset the acquisition cost.
METHODS: An individual patient simulation cost utility model was adapted to assess the costs and consequences over a time horizon of 20 years. SZC was evaluated against standard of care. Patients could experience acute hyperkalaemia, major adverse cardiovascular events (MACE), hospitalization, or modifications in RAASi therapy based on disease stage or class. K+ coefficients. The main outcomes were total costs, quality-adjusted life years (QALYs), and incremental cost- effectiveness ratio (ICER). Resource utilization in disease health states and acute events managements is gathered from the literature and validated from local clinical experts. Drug costs were collected from UPA while medical resources costs were estimated from the national payer perspective for the 2025 financial year. Both costs and outcomes were discounted at an annual rate of 3.5%,
RESULTS: SZC demonstrated high cost-effectiveness in both heart failure (HF) patients and those with concomitant CKD and HF. In HF patients, SZC yielded an incremental QALY gain of 0.976 QALYs with an incremental total cost of 193,121 EGP ($3,862), resulting in an ICER of 197,951EGP ($3,959)/QALY. For patients with both CKD and HF, SZC provided an incremental QALY gain of 0.736 QALYs at an incremental total cost of 181,349 EGP ($3,627), leading to an ICER of 246,415 EGP ($4,928)/QALY. Both ICERs fall below the WTP threshold of 427,866 EGP ($8,557) per QALY
CONCLUSIONS: For CKD and HF patients with hyperkalaemia, SZC offers a cost-effective option from the Egyptian national payer perspective. Over a 20-year horizon, improved survival and reduced HK-related hospitalizations offset the acquisition cost.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE384
Topic
Economic Evaluation
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Urinary/Kidney Disorders