Pharmacoeconomic Analysis: Analysis Of Cost-Effectiveness Of Lanthanum-Carbonate (Lc) In Uncontrolled Hyperphosphatemia In Dialysis.

The objective of this study is to evaluate the difference in terms of efficacy and costs of lanthanum carbonate plus standard therapy (LTS) compared to standard therapy alone (TS) in the treatment of hemodialysis patients with persistent hyperphosphatemia. We selected 14 consecutive patients (8 males and 7 females) on hemodialysis with more than four phosphorus values greater than 6 mg/dL in three months, got them recruited in therapy with lanthanum carbonate. The data analysis has been done considering a phase retrospective (FR) of three months and a phase perspective (FP) of six months, analyzing for each subject consumption and the effectiveness of therapy before and after enrollment. The effectiveness of treatment, was evaluated as the percentage of patients who reached the therapeutic target set by the K/DOQI Guidelines (P<5.5 mg/dL). The economic evaluation was conducted according to the hospital perspective and were considered the only consumption associated with the purchase of the drugs administered. The combination of LC plus standard therapy has produced a significant increase in the percentage of patients who achieved the target range as defined by the K/DOQI Guidelines (+85.16%). The reduction of 21.2 mg/dL (-32.7%) mean phosphorus in FP (4,55 mg/dL) than in the FR (6.77 mg/dL) was statistically significant (p <0.001). The average expected cost/year for patients treated with LC plus standard therapy (€ 2,527.88) was higher of € 419.60 (+ 16.6%) compared to the standard therapy alone (€ 2,108.28). The analysis of cost-effectiveness showed an incremental cost per patient to therapeutic target of € 492.69 for LTS compared to TS (projected annual cost). The introduction of the LC in the treatment of hemodialysis patients with uncontrolled hyperphosphatemia is very cost-effective and has allowed a significant increase in the achievement of therapeutic targets with minimal increase in costs for the National Health System.