COST-EFFECTIVENESS OF PARICALCITOL VERSUS CALCITRIOL FOR MANAGEMENT OF SECONDARY HYPERPARATHYROIDISM IN MAINTAIN HAEMODIALYSIS PATIENTS IN BEIJING

Abstract BACKGROUND AND AIMS To compare the cost efficacy analysis and the effect on calcium and phosphorus variability of paricalcitol and calcitriol in the treatment of haemodialysis CKD-MBD patients in Beijing from the payer's perspective. METHOD Patients were divided into the paricalcitol group and the calcitriol group, and both groups could be treated with a combination of cinacalcet. The treatment duration was 6 months, and the attainment endpoint was a mean iPTH ≤ 300 pg/mL in the 4th–6th month of treatment. Efficacy was the attainment rate of patients in both groups. The cost is the sum of medications and laboratory tests over a 6-month period. We evaluated incremental cost-efficacy analysis (ICER) and plotted to scatter plots of incremental cost-effects using nonparametric Bootstrap repeated sampling 1000 times. A one-way sensitivity analysis of factors affecting ICER was also performed, and a probabilistic sensitivity analysis of parametric random sampling was performed using Monte Carlo simulation. The calcium and phosphorus smoothing index (SI) was applied to assess the effect of treatment on calcium and phosphorus variability. RESULTS The effective rates in the two groups were 88.7% (paricalcitol group) and 56.5% (calcitriol group), respectively. The cost-effect basis analysis showed that the ICER of paricalcitol and calcitriol and was CNY 41 554.702. The single-factor sensitivity analysis showed that the price of paricalcitol is the most sensitive factor, and the probabilistic sensitivity analysis showed that paricalcitol was a more economical solution when the willingness to pay (WTP) was above CNY 32 500. There are no differences of the calcium and phosphorus SI between two groups. CONCLUSION Paricalcitol has an economic advantage when the 6-month WTP is CNY 32 500 or more per effective patient treated.