WASHINGTON, Dec. 1 (UPI) -- A recent study suggests that sevelamer, sold as Renagel by Genzyme, Cambridge, Mass.,-- and a relatively pricey therapy -- is actually cost-effective because it appears to reduce heart attacks in patients with kidney diesase.
The study of Renagel -- used to lower phosphorus levels in patients with severe kidney disease -- was published in the September/October issue of Value in Health.
The research -- presented at the recent conference of the American Society of Nephrology and the American Heart Association --
was performed by the Caro Research Institute based in Concord, Mass.
Genzyme wanted to show that its drug would reduce the number of heart attacks in patients with severe kidney disease to boost its product's market performance.
The company asked Caro to help by performing a so-called discrete event simulation. To do this, the institute took data from an earlier Genzyme study, plus two long-term studies on the effects of elevated calcium on cardiovascular disease.
It then extrapolated the data for a full year to determine whether Renagel's lack of calcium would decrease artery calcifications and lower the number of adverse cardiovascular events.
The results suggested that Renagel did just that and could indeed be used in a way that trimmed costs. The reduced number of cardiac problems lowered the overall cost of treatment, researchers said, and created a favorable cost-effectiveness ratio of about $2,200 of increased cost per life year gained.
What's more, experience in the field appears to support that finding.
Mohamed Atta, medical director of the Outpatient Dialysis Center at Johns Hopkins Medical Center, told UPI he considered Renagel an extremely useful medication, but thought there were ways to make it even more effective.
"We use Renagel in our clinic on a regular basis to control phosphorus for our dialysis patients," Atta said. "It contains no calcium and also lowers lipids, so our patients have a lower risk of calcium deposits in their coronary arteries and a lower risk of cardiovascular events.
But despite its cost-effecitveness, some issues remain.
"The big problem with this medication is compliance. Patients on Renagel must take 8 to 16 large pills a day. We can't control the phosphorus with less than eight. They don't like to do this, so their phosphorus levels are sometimes not as low as we would like. Those of us in the field would like to see Genzyme make Renagel in a form that requires only two to four pills a day so we could feel confident that our patients would take the dose we recommend for good phosphorus control," Atta said.
