Cinacalcet for the treatment of secondary hyperparathyroidism in end stage renal failure and economic evaluation
Lee SW, Ku Nurhasni KA, Hanin FK, Junainah S
Record ID 32018001254
English
Authors' objectives:
To assess the safety, effectiveness and cost implication of cinacalcet as compared with vitamin D analogues such as calcitriol, alpha-calcidol and parathyroidectomy for the treatment of secondary hyperparathyroidism in patients with end stage renal failure.
Authors' results and conclusions:
Safety:
The most common adverse event associated with cinacalcet therapy was gastrointestinal side effects. Cinacalcet increased nausea, vomiting and the rate of hypocalcemia.
Effectiveness:
Cinacalcet did not reduce all-cause mortality, cardiovascular mortality, hospitalisations due to cardiovascular events and fracture. However, cinacalcet was found to be more effective at meeting parathyroid hormone target level and reduce the incidence and needs for parathyroidectomy.
Cost-effectiveness:
Cost-effectiveness studies were done to compare cinacalcet and standard treatment with placebo and standard treatment. Different willingness-to-pay (WTP) threshold was used to decide the cost-effectiveness of cinacalcet treatment in different country. In United States, cinacalcet treatment was found to be cost-effective at the threshold of USD 100,000 per quality adjusted life year (QALY) while in United Kingdom, cinacalcet was found to be not cost-effective at the threshold of £30,000. A cost-utility study found parathyroidectomy to be more cost-effective compared to cinacalcet treatment after 7.25 ± 0.25 months.
Financial implication:
The total cost for cinacalcet treatment will be higher compared to parathyroidectomy. Parathyroidectomy will be costly at the beginning of year one but the cost will be much lower at the subsequent years.
Authors' recommendations:
Cinacalcet is more costly when compared to parathyroidectomy. However, it may be used for the treatment of secondary hyperparathyroidism in end stage renal disease patients in whom surgical treatment is contraindicated or the risk of surgery is considered to outweigh the benefits.
Authors' methods:
The following electronic databases were searched through the Ovid interface: Ovid MEDLINE® and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions® 1946 to present, EBM Reviews - Health Technology Assessment (1st Quarter 2019), EBM Reviews - Cochrane Database of Systematic Review, EBM Reviews - Cochrane Central Register of Controlled Trials. Parallel searches were run in PubMed, US FDA and INAHTA database. No limits were applied to the search. Additional articles were identified from reviewing the references of retrieved articles.
Details
Project Status:
Completed
Year Published:
2020
URL for published report:
https://www.moh.gov.my/index.php/database_stores/store_view_page/30/347
Requestor:
Decision making committee
English language abstract:
An English language summary is available
Publication Type:
Mini HTA
Country:
Malaysia
MeSH Terms
- Cinacalcet
- Costs and Cost Analysis
- Drug-Related Side Effects and Adverse Reactions
- Hyperparathyroidism
- Parathyroid Hormone
Contact
Organisation Name:
Malaysian Health Technology Assessment
Contact Address:
Malaysian Health Technology Assessment Section, Ministry of Health Malaysia, Federal Government Administrative Centre, Level 4, Block E1, Parcel E, 62590 Putrajaya Malaysia Tel: +603 8883 1229
Contact Name:
htamalaysia@moh.gov.my
Contact Email:
htamalaysia@moh.gov.my
Copyright:
Malaysian Health Technology Assessment Section (MaHTAS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.