OBJECTIVES:

Sucroferric oxyhydroxide (SFOH) is a non-calcium, iron-based phosphate binder indicated for the control of serum phosphorus (sPhos) levels in chronic kidney disease patients on hemodialysis or peritoneal dialysis. A US retrospective analysis demonstrated that, after 3 and 6 months, switching from sevelamer (SEV) to SFOH increased the proportion of patients with in-range sPhos (3.5-5.5 mg/dl) by 74-98%, while reducing pill burden (PB) by 61-62%. Post-hoc analyses of SFOH showed no apparent interaction with oral Vitamin D (VDRAs) contrary to SEV’s potential interactions. The objective of this analysis is to quantify the economic impact of using SFOH vs. SEV in Belgium and the Netherlands.

METHODS:

Drug acquisition costs were obtained from official list prices and applied to the PB observed in the retrospective analysis. SEV cost was weighted for market shares amongst originators and generics. Number needed to treat to achieve in-range sPhos were used to calculate 3 and 6-monthly costs per responder. Sensitivity analysis (SA) for the PB was conducted. Cost-savings from preventing patients switching from oral to IV VDRAs were calculated, excluding administration and adverse events costs.

RESULTS:

In Belgium, the 3 and 6-monthly cost per responder for SFOH was EUR2,865 and EUR5,032, respectively, and for SEV was EUR4,699 and EUR7,9412, respectively. In the Netherlands, the 3 and 6-monthly cost per responder for SFOH was EUR2,273 and EUR3,992, respectively, and for SEV was EUR3,650 and EUR7,299, respectively. SA showed lower cost per responder for SFOH, when relative PB was varied, for both countries. The average annual cost-savings of preventing one patient from switching to IV from oral VDRAs were EUR217 (Belgium) and EUR72 (Netherlands).

CONCLUSIONS:

SFOH appears to attain in-range sPhos at a lower cost compared to SEV and may result in additional cost-savings due to less patients switching from oral to costlier IV VDRAs, suggesting favorable cost-effectiveness.