Cinacalcet adherence in dialysis patients with secondary hyperparathyroidism in Lombardy Region: clinical implications and costs.

SHPT cinacalcet costs dialysis therapeutic adherence

Journal

Drugs in context
ISSN: 1745-1981
Titre abrégé: Drugs Context
Pays: England
ID NLM: 101262187

Informations de publication

Date de publication:
2020
Historique:
received: 01 01 2020
revised: 01 03 2020
accepted: 06 03 2020
entrez: 11 4 2020
pubmed: 11 4 2020
medline: 11 4 2020
Statut: epublish

Résumé

Patients on dialysis often have secondary hyperparathyroidism (SHPT), a disorder associated with renal osteodystrophy, progressive vascular calcification, cardiovascular disease, and death. The objective of this retrospective observational study was to evaluate, in dialysis patients with SHPT, the impact of different levels of adherence to cinacalcet therapy on hospitalisations and direct healthcare costs charged to the Lombardy Regional Health Service (Italy). Data recorded in the administrative databases on all citizens undergoing dialysis between 1 January 2011 and 31 December 2011 were selected. For the aim of this study, patients with SHPT already on dialysis in the first 6 months of 2009 who had been treated with cinacalcet for at least 365 days were selected and retrospectively analysed through to end of 2012. Healthcare resource utilisation, cinacalcet adherence, and costs for medication, hospitalisations, and diagnostic/therapeutic procedures were estimated. A total of 994 patients were identified (mean age 63.0 years, females 43.5%). The first patient tertile had an adherence to cinacalcet of <64.1%, whereas the third had an adherence of over 91.5%. Patients in the third adherence tertile experienced fewer all-causes hospitalisations than those in the first tertile (-19.2%; The results of the analysis suggest that there may be some correlation between a high level of cinacalcet adherence and a decrease in hospitalisations.

Sections du résumé

BACKGROUND BACKGROUND
Patients on dialysis often have secondary hyperparathyroidism (SHPT), a disorder associated with renal osteodystrophy, progressive vascular calcification, cardiovascular disease, and death. The objective of this retrospective observational study was to evaluate, in dialysis patients with SHPT, the impact of different levels of adherence to cinacalcet therapy on hospitalisations and direct healthcare costs charged to the Lombardy Regional Health Service (Italy).
METHODS METHODS
Data recorded in the administrative databases on all citizens undergoing dialysis between 1 January 2011 and 31 December 2011 were selected. For the aim of this study, patients with SHPT already on dialysis in the first 6 months of 2009 who had been treated with cinacalcet for at least 365 days were selected and retrospectively analysed through to end of 2012. Healthcare resource utilisation, cinacalcet adherence, and costs for medication, hospitalisations, and diagnostic/therapeutic procedures were estimated.
RESULTS RESULTS
A total of 994 patients were identified (mean age 63.0 years, females 43.5%). The first patient tertile had an adherence to cinacalcet of <64.1%, whereas the third had an adherence of over 91.5%. Patients in the third adherence tertile experienced fewer all-causes hospitalisations than those in the first tertile (-19.2%;
CONCLUSIONS CONCLUSIONS
The results of the analysis suggest that there may be some correlation between a high level of cinacalcet adherence and a decrease in hospitalisations.

Identifiants

pubmed: 32273898
doi: 10.7573/dic.2020-1-1
pii: dic-2020-1-1
pmc: PMC7111129
pii:
doi:

Types de publication

Journal Article

Langues

eng

Informations de copyright

Copyright © 2020 Roggeri A, Conte F, Rossi C, Cozzolino M, Zocchetti C, Roggeri DP.

Déclaration de conflit d'intérêts

Disclosure and potential conflicts of interest: Alessandro Roggeri and Daniela Paola Roggeri report consultancy fees from AstraZeneca and Amgen, outside the submitted work. Mario Cozzolino reports personal fees from Vifor Pharma, personal fees from Amgen, grants and personal fees from Shire, and grants and personal fees from Baxter, outside the submitted work. All other authors declare that they have no conflict of interest. https://www.drugsincontext.com/wp-content/uploads/2020/03/dic.2020-1-1-COI.pdf

Références

Ther Clin Risk Manag. 2017 Jun 01;13:679-689
pubmed: 28615947
Clin J Am Soc Nephrol. 2011 Apr;6(4):913-21
pubmed: 21454719
Nephrol Dial Transplant. 2015 Jan;30(1):39-44
pubmed: 24516224
Clin Transplant. 2019 Oct;33(10):e13728
pubmed: 31587354
J Immunol. 2004 Sep 1;173(5):2909-12
pubmed: 15322146
Inflamm Res. 2014 Oct;63(10):803-19
pubmed: 25048990
J Am Heart Assoc. 2014 Nov 17;3(6):e001363
pubmed: 25404192
Eur J Intern Med. 2017 Jul;42:89-95
pubmed: 28499709
J Med Econ. 2011;14(6):798-804
pubmed: 21988567
N Engl J Med. 2012 Dec 27;367(26):2482-94
pubmed: 23121374
J Am Board Fam Med. 2009 Sep-Oct;22(5):574-81
pubmed: 19734404
BMC Nephrol. 2019 May 14;20(1):169
pubmed: 31088377
Ann Nutr Metab. 2018;72(2):87-95
pubmed: 29346788
PLoS One. 2012;7(10):e48070
pubmed: 23133549
PLoS One. 2019 May 29;14(5):e0216399
pubmed: 31141505
Nephrol Dial Transplant. 2014 Oct;29(10):1815-20
pubmed: 24516228
Kidney Int Suppl (2011). 2013 Dec;3(5):431-435
pubmed: 25028644
Kidney Int Suppl (2011). 2017 Jul;7(1):1-59
pubmed: 30675420
Clin J Am Soc Nephrol. 2015 May 7;10(5):791-9
pubmed: 25710802
Pharm Stat. 2015 May-Jun;14(3):242-51
pubmed: 25851955
Clin Kidney J. 2019 Mar 18;12(6):871-879
pubmed: 31807302
Am J Kidney Dis. 2003 Jul;42(1):125-32
pubmed: 12830464
Blood Purif. 2019;47(1-3):37-44
pubmed: 30223271
Int J Nephrol. 2015;2015:184321
pubmed: 25918645
Hemodial Int. 2010 Jan;14(1):68-72
pubmed: 19732171
Nephrol Dial Transplant. 2011 Nov;26(11):3659-66
pubmed: 21372255
J Am Soc Nephrol. 2005 Mar;16(3):800-7
pubmed: 15689407
N Engl J Med. 2004 Apr 8;350(15):1516-25
pubmed: 15071126

Auteurs

Alessandro Roggeri (A)

ProCure Solutions, Nembro, Italy.

Ferruccio Conte (F)

Department of Health Sciences, Renal Division, University of Milan, San Paolo Hospital, Milan, Italy.

Carlotta Rossi (C)

ProCure Solutions, Nembro, Italy.

Mario Cozzolino (M)

Department of Health Sciences, Renal Division, University of Milan, San Paolo Hospital, Milan, Italy.

Carlo Zocchetti (C)

Lombardy Region, Regional Health Authority, Milan, Italy.

Daniela Paola Roggeri (DP)

ProCure Solutions, Nembro, Italy.

Classifications MeSH