OBJECTIVES: Hyperkalemia is an electrolyte abnormality with potentially life-threatening consequences. The potassium-binding polymer patiromer (Veltassa™) is associated with reduced rates of severe edema and hospitalization for heart failure compared with sodium zirconium cyclosilicate (SZC, Lokelma™) when treating hyperkalemia. The aim of this study was to evaluate the costs associated with these interventions in the UK, Italian and Spanish settings.

METHODS: A model was developed in Microsoft Excel to compare the costs associated with patiromer and SZC for the management of hyperkalemia. Clinical event rates were taken from a published real-world comparative study, with the base case capturing the statistically significant reduction in severe edema (treated either in the emergency department or as an inpatient) with patiromer versus SZC and a sensitivity analysis also including the non-statistically significant reduction in hospitalization for heart failure. Country-specific costs, expressed in 2022 British pound sterling (GBP) and Euros (EUR), were evaluated from a healthcare payer perspective and included pharmacy costs and costs of clinical events.

RESULTS: Patiromer was associated with cost savings of GBP 630, EUR 1,197 and EUR 107 per patient-year of treatment versus SZC in the UK, Italy and Spain, respectively. The majority of cost savings were due the lower daily cost of patiromer compared with SZC. Including the difference in heart failure hospitalization rates in a sensitivity analysis led to greater cost savings with patiromer over SZC, increasing to GBP 902, EUR 1,524 and EUR 460 in the UK, Italy and Spain, respectively. Extrapolation of patient-level outcomes to a population level found that patiromer was associated with annual cost savings of GBP 801.7 million in the UK, EUR 24.7 million in Italy and EUR 30.6 million in Spain versus SZC.

CONCLUSIONS: Patiromer was projected to be cost saving versus SZC for the treatment of hyperkalemia in the UK, Italy and Spain.