Budget impact analysis of the use of paricalcitol for the treatment of secondary hyperparathyroidism in chronic kidney disease

OBJECTIVE: Evaluation of the budget impact of the use of paricalcitol (compared to alternative treatment) for secondary\udhyperparathyroidism (SHPT) in patients with chronic kidney disease (CKD) when used at two different timing of therapy.\udMETHODS: Two Markov models related to a different timing of treatment have been developed: the intermediate stage of\udchronic kidney disease (CKD3) and the dialysis stage. The analysis was conducted with the perspective of the Italian National\udHealth System and over a 5-year time horizon. The clinical and economic data used in the model were derived from\udthe literature and other assumptions were made based on the opinion of clinical experts. Univariate sensitivity analysis was\udconducted to test the robustness of the results.\udRESULTS: The base case shows that starting paricalcitol treatment from the dialysis stage (considering 13,311\udpossible candidates) is associated with a reduction in direct costs from € 1,782,921,351 to € 1,622,357,209\udover 5 years. Furthermore, considering a collective of 1,000 subjects eligible and starting treatment with paricalcitol\udsince the intermediate stages of the CKD, is associated with an overall cost saving of € 1,197,500.\udDISCUSSION AND CONCLUSIONS: Paricalcitol is expected to be cost-saving in patients with SHPT in Italy considering\udboth the therapeutic indications of the drug. Moreover, despite the higher cost of using paricalcitol in pre-dialysis stage, an\udearly treatment of SHPT determine an overall decrease in direct medical costs