FP607EFFICAY AND COST SAVINGS OF THE NEW IRON-BASED PHOSPHATE BINDER IN HEMODIALYSIS PATIENTS

Abstract

Introduction and Aims: The novel iron-based and non-calcium-based phosphate binder sucroferric oxyhydroxide (SO) has shown similar efficacy to sevelamer carbonate in the treatment of hyperphosphatemia. The aim of this study is to evaluate the efficacy and the total cost of mineral and bone disorder (MBD) medications in Spanish hemodialysis patients who, according to clinical practice, shift a non-iron non-calcium PB (NINC-PB) to the new iron-based SO. Methods: Retrospective non intervention study in Spanish patients of Euclid ® data base in treatment with NINC-PB (sevelamer carbonate or lanthanum carbonate) who changed between June 2016 and January 2017 to SO, regardless of whether they were taking calcium-based PB (calcium carbonate or calcium acetate) concomitantly. The patients could be taken combination therapy to treat high serum phosphorus. The percent of patients with prescription of PB and the doses and the variables serum calcium (Ca), phosphorus (Ph) and parathyroid hormone (PTH) was collected two months before the change (basal) and in months 3rd and 4th after the change (post). The total cost of MBD medication was collected (including calcium and non-calcium-based PB, cinacalcet and active vitamin D). Costs are shown in euros per dialysis session according to laboratory sale prices. Results: One hundred and sixty-five prevalent hemodialysis patients (17-78 months) of 39 Spanish centers of 61,3 6 14,4 years old (37,6% female) in whom NINC-PB was changed to SO, were evaluated. The prescription of calcium-based PB decreased from 44.9% to 35.8% and NINC-PB from 100% to 49.7%. Four months after the change 71.5% patients were still taking SO. Basal versus post values of Ca, Ph and PTH; and the cost of non calcium PB are in Figure. The total cost of MBD was 19.6 vs 17.31 euros (p<0.01), see Figure. [Figure Presented] Conclusions: The switch of non-calcium PB prescription to the novel iron-based sucroferric oxyhydroxide, according to regular clinical practice, allowed to significantly reduce the total cost of medication for mineral bone disorders and the cost of non-calcium-based PB, with better control of hyperphosphatemia in prevalent hemodialysis patients.