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Cost‐effectiveness of the oral adsorbent AST‐120 versus placebo for chronic kidney disease
Author(s) -
TAKAHASHI TOMOHIKO,
REED SHELBY D,
SCHULMAN KEVIN A
Publication year - 2008
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2008.00960.x
Subject(s) - medicine , placebo , kidney disease , creatinine , population , renal function , surgery , pathology , alternative medicine , environmental health
SUMMARY: Aim: This study was designed to evaluate the cost‐effectiveness of AST‐120, an oral adsorbent that attenuates the progression of chronic kidney disease. Methods: We developed a Markov model with six health states, including four levels of serum creatinine, haemodialysis and death, using data from a randomized clinical trial conducted in Japan. Direct costs relevant to chronic kidney disease were calculated from a Japanese reimbursement perspective. Projected quality‐adjusted life years (QALY) and costs were compared between the AST‐120 and placebo groups. The target population was nondiabetic patients with serum creatinine levels from 5.0 to 8.0 mg/dL (442–707 µmol/L) at baseline. Probabilistic sensitivity analysis was performed to evaluate the stability of the results. Results: At 3 years, mean total costs per patient were estimated at ¥6.67 million (US$56 982) in the AST‐120 group and ¥9.38 million (US$80 196) in the placebo group. Mean total costs were ¥2.72 million (US$23 205) lower among patients receiving AST‐120. QALY per patient were 0.295 (approximately 3.5 months) greater for patients receiving AST‐120 than for those receiving placebo over 3 years. The finding that treatment with AST‐120 dominated placebo (i.e. was less costly and resulted in more QALY) was upheld in sensitivity analyses. Conclusion: The use of AST‐120 in patients with advanced chronic kidney disease may help to slow the rate of growth in expenditures for kidney disease.