Sucroferric oxyhydroxide linked to fewer hospital admissions, lower cost of care
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Data from Fresenius Medical Care North America-directed ESRD Seamless Care Organizations show the type of phosphate binder used by clinics during the demonstration influenced hospital admissions and overall cost of care, according to an abstract at the virtual National Kidney Foundation Spring Clinical Meetings.
The Centers for Medicare & Medicaid Innovation developed the Comprehensive ESRD Care (CEC) model and launched the program in 2015. The CEC began as a 3-year demonstration with an option for 2 additional years. The program is expected to run through the end of 2020. Fresenius Medical Care North America (FMCNA) operates 23 of the existing 36 ESCOs, providing care to almost 50,000 Medicare ESRD beneficiaries.
The aim of the analysis was to assess hospitalizations and costs associated with various phosphate binders prescribed to patients on dialysis in Fresenius-operated ESCOs.
“By providing high-quality care, ESCOs may control costs by avoiding unnecessary [hospitalizations],” Kristain Lindemann, of Fresenius Health Partners in Waltham, Massachusetts, wrote in the abstract.
Patients from 24 Fresenius ESCOs with phosphate binders prescribed during 2016 through 2018 and intact parathyroid levels of less than 600 pg/m were included in the discussion. Hospital admissions and member months were used to calculate hospital admission rates and rate ratios. Total costs of care were calculated per member per month during a 3-year study period.
FMCNA’s Renal Pharmaceuticals division sells sucroferric oxyhydroxide (SO) as Velphoro, one of the binders used in the analysis.
According to Lindemann, researchers found hospital admission rates were lowest in patients prescribed sucroferric oxyhydroxide (7.96 per 100 member months, hospital admission rate ratio of 1) compared to sevelamer, calcium acetate (CaAC), ferric citrate and lanthanum carbonate. Patients treated with the other phosphate binders experienced hospital admission rates of 11%, 20%, 32% and 42% higher than those treated with sucroferric oxyhydroxide.
Total per member per month health care costs were lower with sucroferric oxyhydroxide ($5,670) compared to sevelamer ($6,354), calcium acetate ($6,303), ferric citrate ($5,908) and lanthanum carbonate ($6,104).
“In this analysis, data from 24 ESCOs showed differences in hospital admission rates with the lowest rate in SO and the highest in CaAC,” Lindemann wrote. “In addition, the total costs of care per [member months] MM where SO was prescribed were lower when compared to other phosphate binders.” – by Erin T. Welsh
References:
https://fmcna.com/insights/education/what-is-an-esco-/
Lindemann K. Abstract #209. Presented at: National Kidney Foundation Spring Clinical Meetings; March 26-29, 2020 (virtual meeting).
Disclosure: Lindemann reports being employed by Fresenius Health Partners.
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