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Abstract: PO0371

An Observational Analysis of Hospital Admissions and Total Member Costs Associated with the Use of Various Phosphate Binders Used in Dialysis Patients Included in ESRD Seamless Care Organizations

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Lindemann, Kristain C., Fresenius Health Partners, Waltham, Massachusetts, United States
  • Ajala, Christiana, Fresenius Health Partners, Waltham, Massachusetts, United States
  • Rosen, Melissa M., Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
  • Mullon, Claudy, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
  • Kossmann, Robert J., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Ketchersid, Terry L., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Ficociello, Linda, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
Background

A prior observational study using real world data and estimates of hospitalization costs based on national data, found patients continuing sucroferric oxyhydroxide (SO) therapy had fewer hospital admissions and expected lower healthcare costs when compared to patients switching to another phosphate binder (PB). End Stage Renal Disease (ESRD) Seamless Care Organizations (ESCOs) coordinate treatment for 10% of Medicare dialysis patients in the U.S. By providing quality care, ESCOs may control costs by avoiding unnecessary hospitalizations. The aim of this analysis was to assess hospitalizations and costs associated with various PBs prescribed to dialysis patients in ESCOs.

Methods

Patients included in the analysis had PBs prescribed during 2016-2018 in ESCOs along with parathyroid (PTH) levels <600 pg/ml. Aggregated utilization and cost data from 24 ESCOs were used over 3 years. Total hospital admissions and member months (MM) were used to calculate hospital admission rates and rate ratios. The statements contained in this document are solely those of the authors and do not necessarily reflect the view or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.

Results

Hospital admission rates were found to be lower for SO (Table). Compared to MM treated with SO, an increased hospital admission rate of 11%, 20%, 32%, and 42% was observed for MM treated with SEV, CaAC, FC, and LC, respectively. In addition, the total per member per month (PMPM) healthcare costs were lower for SO ($5670) compared to FC ($5908), LAN ($6104), CaAC ($6303), and SEV ($6354), respectively.

Conclusion

Data from 24 ESCOs showed differences in hospital admission rates with the lowest rate in SO (7.97 per 100-member month (MM)) and the highest in CaAc (11.28 per 100- MM). In addition, total costs of care per MM where SO was prescribed were lower when compared to other PBs.

Phosphate Binder# hospital admissionsMember Months (MM)Hospital Admission Rate per 100 MMHospital Admission Rate ratioRate Ratio 95% CI
sucroferric oxyhydroxide (SO)896112397.971--
Sevelamer (SEV)1410913412510.521.321.23, 1.41
Calcium Acetate (CaAC)1142910130211.281.421.32, 1.52
Ferric Citrate (FC)86991119.541.201.09, 1.31
Lanthanum carbonate (LC)40245388.861.110.99, 1.25

Funding

  • Commercial Support