Economic evaluations of interventions to manage hyperphosphataemia in adult haemodialysis patients: A systematic review

被引:14
作者
Rizk, Rana [1 ]
Hiligsmann, Mickael [1 ]
Karavetian, Mirey [2 ]
Evers, Silvia M. A. A. [1 ]
机构
[1] Maastricht Univ, CAPHRI Sch Publ Hlth & Primary Care, Dept Hlth Serv Res, NL-6200 Maastricht, Netherlands
[2] Zayed Univ, Coll Sustainabil Sci & Humanities, Dept Nat Sci Publ Hlth, Dubai, U Arab Emirates
关键词
chronic; cost-benefit analysis; hyperphosphataemia; kidney failure; renal dialysis; CHRONIC KIDNEY-DISEASE; STAGE RENAL-DISEASE; COST-EFFECTIVENESS; LANTHANUM CARBONATE; PHOSPHATE BINDERS; AORTIC CALCIFICATION; DIALYSIS OUTCOMES; PRACTICE PATTERNS; SEVELAMER; CALCIUM;
D O I
10.1111/nep.12584
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Managing hyperphosphataemia in haemodialysis patients is resource-intensive. A search for cost-effective interventions in this field is needed to inform decisions on the allocation of healthcare resources. NHSEED, MEDLINE, EMBASE and CINAHL were searched for full economic evaluations of hyperphosphataemia-managing interventions in adult haemodialysis patients, published between 2004 and 2014, in English, French, Dutch or German. Incremental cost-effectiveness ratios of the interventions were up-rated to 2013US$ using Purchasing Power Parity conversion rates and Consumer Price Indices. The quality of included studies was assessed using the Extended Consensus on Health Economic Criteria List. Twelve out of the 1681 retrieved records fulfilled the inclusion criteria. They reported only on one aspect of hyperphosphataemia management, which is the use of phosphate binders (calcium-based and calcium-free, in first-line and sequential use). No economic evaluations of other phosphorus-lowering interventions were found. The included articles derived from five countries and most of them were funded by pharmaceutical companies. The incremental cost-effectiveness ratios of phosphate binders ranged between US$11461 and US$157760 per quality-adjusted life-year gained. Calcium-based binders (especially calcium acetate) appear to be the optimal cost-effective first- and second-line therapy in prevalent patients, while the calcium-free binder, lanthanum carbonate, might provide good value for money, as second-line therapy, in incident patients. The studies' overall quality was suboptimal. Drawing firm conclusions was not possible due to the quality heterogeneity and inconsistent results. Future high-quality economic evaluations are needed to confirm the findings of this review and to address other interventions to manage hyperphosphataemia in this population. Summary at a Glance This is an interesting systematic review of studies specifically addressing the economic evaluation of interventions to lower phosphate in dialysis patients. Only 12 studies provided information, all relating to phosphate binders. In general, the overall quality of these studies was suboptimal; therefore, firm conclusions were difficult to be drawn about which binders were best, although calcium-based binders seemed most cost-effective as first-line therapy.
引用
收藏
页码:178 / 187
页数:10
相关论文
共 59 条
[1]   State of health economic evaluation research in Saudi Arabia: a review [J].
Al-Aqeel, Sinaa A. .
CLINICOECONOMICS AND OUTCOMES RESEARCH, 2012, 4 :177-184
[2]  
[Anonymous], AM SOC NEPHROL
[3]  
[Anonymous], 2014, PPPS EXCH RAT
[4]  
[Anonymous], HYP CHRON KIDN DIS C
[5]  
[Anonymous], MONTHL COMP PRIC LEV
[6]  
[Anonymous], J NEPHROL
[7]  
Bernard Lisa, 2013, J Med Econ, V16, P1, DOI 10.3111/13696998.2012.718019
[8]   Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patients [J].
Block, G. A. ;
Raggi, P. ;
Bellasi, A. ;
Kooienga, L. ;
Spiegel, D. M. .
KIDNEY INTERNATIONAL, 2007, 71 (05) :438-441
[9]  
Braun J, 2004, CLIN NEPHROL, V62, P104
[10]   The cost-effectiveness of lanthanum carbonate in the treatment of hyperphosphatemia in patients with end-stage renal disease [J].
Brennan, Alan ;
Akehurst, Ron ;
Davis, Sarah ;
Sakai, Hana ;
Abbott, Victoria .
VALUE IN HEALTH, 2007, 10 (01) :32-41