Research Article
Cost-Effectiveness Analysis for the Treatment of Hyperphosphatemia in Predialysis Patients: Calcium-Based versus Noncalcium-Based Phosphate Binders
| Parameter | Sevelamer | CaCO3 | Unit | Source |
| Population characteristics | | | | | Mean age at baseline | 57.9 | 57.9 | year | Di Iorio 2012 | Baseline serum phosphate level | 4.82 | 4.87 | mg/dl | Di Iorio 2012 | CKD stage 3 | 50 | 50 | % | Assumption derived from Di Iorio 2012 | CKD stage 4 | 50 | 50 | % | Assumption derived from Di Iorio 2012 |
| Drug treatment | | | | | Sevelamer dose | 2.184 | n/a | g/day | Di Iorio 2012 | CaCO3 dose | n/a | 2.950 | g/day | Di Iorio 2012 | Drug cost | 5.0069 | 0.0871 | RM/g | Sevelamer cost: Sanofi, CaCO3 cost: IMS 2013 |
| Efficacy | | | | | Survival up to 36 months | Figure 2 | Figure 2 | | Modelled from INDEPENDENT-CKD data | Dialysis initiation up to 36 months | Figure 3 | Figure 3 | | Modelled from INDEPENDENT-CKD data | Long-term survival | Figure 2 | Figure 2 | | Modelled from INDEPENDENT-CKD data | Long-term dialysis initiation | Figure 3 | Figure 3 | | Modelled from INDEPENDENT-CKD data |
| Utility | | | | | Pre-dialysis CKD utility | 0.86 | 0.86 | | Gorodetskaya 2005; weighted average of utility in stage 4 and 5 CKD | Dialysis utility | 0.8 | 0.8 | | Bavanandan 2010 |
| Dialysis | | | | | Proportion of patients on HD | 88 | 88 | % | 21st MDTR 2013 | Proportion of patients on CAPD | 12 | 12 | % | 21st MDTR 2013 | HD cost | 259.09 | 259.09 | RM/ session | Hooi 2005, IMF 2013 | CAPD cost | 99.04 | 99.04 | RM/day | Hooi 2005, IMF 2013 |
| Base case modelling parameters | | | | | Cohort size | 1000 | 1000 | patient | Assumption | Time horizon | 60 | 60 | year | Assumption | Discount rate on costs | 3 | 3 | % | Malaysian PE Guidelines 2012 | Discount rate on outcomes | 3 | 3 | % | Malaysian PE Guidelines 2012 |
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