Comparative cost-benefit analyses of paricalcitol and calcitriol in stage 4 chronic kidney disease from the perspective of a health plan

Substantial data for the relative costs of hospitalisation in paricalcitol- and calcitriol-treated patients with chronic kidney disease stage 4 do not exist. The objective of this study was to compare the cost benefit of paricalcitol and calcitriol therapies in chronic kidney disease stage 4 from the perspective of a healthcare payer. A range of methods were used to estimate the relative costs of hospitalisation in paricalcitol- and calcitriol-treated patients with chronic kidney disease stage 4, extrapolated from observed differences in hospitalisation costs in stage 5 patients. Different values and approaches were used to show a range of values and to show the specific hospitalisation benefit in terms of the all-cause hospitalisation rate and number of all-cause hospital days. The annual dollar impact of use of paricalcitol instead of calcitriol on all-cause hospital admissions was calculated to be a reduction of $US1220-$US4476 and for all-cause number of hospital days a reduction of $US1816-$US8776. A total of 42 cost comparison estimates were generated to compare the cost benefit of calcitriol or paricalcitol. Of these 42 comparisons, 35 showed that the total cost of paricalcitol was lower than the total cost of calcitriol therapy. The cost advantage of paricalcitol over calcitriol substantially increased as patients progressed toward dialysis. Cost analyses suggest that paricalcitol-treated patients have a lower total cost than calcitriol-treated patients.