OBJECTIVES

: Hyperphosphatemia is a common complication in patients with chronic renal disease (CRD), characterized by the elevation of phosphate blood levels (above 4.5mg/dL), resulting in an hydroelectrolytic imbalance and developing into acute renal impairment, renal nephropathy and increase risk of death. Treatment options include phosphorus and sodium restrictions in diet, increase dialysis frequency and the use of phosphorus chelants, such as Sevelamer (carbonate of clorhidrate). Both alternatives have similar efficacy and safety in the treatment of this pathology. It was developed a complete and a parcial economic evaluation study of sevelamer carbonate (SCa) in the treatment of hyperphosphatemia in patients with CRD in comparison with sevelamer clorhidrate (SCl).

METHODS

: A cost-minimization analysis (CMA), from the IMSS perspective, was developed to compare the resource use with SCa and SCl in the treatment of hyperphosphatemia in patients with CRD. The study considered a time horizon of 1 year and costs published by public health institutions. Deterministic sensitivity analysis were performed on the variables that could generate uncertainty.

A budget impact analysis (BIA) was developed to evaluate the costs associated with the use of SCa in this target population, from IMSS perspective, considering a 5 year-horizon, annual cycles, and a market share of SCa increased 10% per year. Costs are expressed in Mexican pesos.

RESULTS

: The CMA demonstrated that the annual cost of treatment with SCa is $34,224.83 and with SCl is $34,775.62, resulting in a cost-saving per patient with of $550.78 with SCa. The BIA showed that the introduction of SCa in the market produce an average cost saving per year of $1,126,556.65 which represents 0.002% of the IMSS assigned drug budget.

CONCLUSIONS

: The use of SCa represents not only health but also economic benefits in the treatment of hyperphosphatemia in patients with CRD, specifically from the IMSS perspective.