Evaluation of Pre-Dialysis Doxercalciferol Use on Health Outcomes and Costs Compared to No Vitamin D Receptor Activator (VDRA) Treatment for Secondary Hyperparathyroidism (SHPT)

Authors:
Qing Harshaw,¹
Dennis L. Andress,²
Steven E. Marx,²
Carla B. Frye,¹
Raimund Sterz,²
Katie L. Deering,¹
Paul Audhya.²

Abstract:

OBJECTIVE:
To evaluate healthcare resource utilization and costs of pre-dialysis use of doxercalciferol compared with no VDRA use.

METHODS:
A retrospective study of 150 pre-dialysis patients per cohort comparing health outcomes and costs of doxercalciferol use compared with no VDRA for SHPT. Cohorts were matched based on age, gender and Charlson Co-morbidity Index, and preindex total costs. Additionally, multivariate analyses were conducted which corrected for differences in age, gender, insurance, physician specialty, region, pre-index co-morbidities, and pre-index costs.

RESULTS:
Matched cohort analysis showed statistically higher annual medication use (61.1 v 45, p<0.001) and medication costs ($12,476 vs $5,011, p<0.0001) for doxercalciferol use compared with no VDRA treatment. No difference was seen in outpatient services, hospitalizations, outpatient costs, hospitalization costs, and total costs. Multivariate analysis demonstrated similar results, higher medication use and cardiovascular-related outpatient visits for doxercalciferol use compared with no VDRA treatment. No difference was seen in cardiovascular-related and all-cause hospitalizations and total costs.

CONCLUSION:
Doxercalciferol treatment of SHPT in pre-dialysis patients is associated with greater medication use and cardiovascular-related outpatient visit compared with no VDRA treatment. No difference in cardiovascular-related and all-cause hospitalizations and total costs was seen between cohorts. Further research is needed to confirm these findings.