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The preparation provides a rendering hypophosphatemic action, i.e. reducing the concentration of phosphates in the body. Unlike some other means, having a similar effect, Sevelamer does not contain calcium, so the risk of hypercalcemia on the background of its admission is estimated at 1.3%.
Indications for use
The medicament is designed prevention of hyperphosphataemia in patients older than 18 years old, suffering from renal failure. Taken in the complex therapy to prevent bone disease, which may be due to kidney failure. Therapy should also include vitamin D3 and calcium supplements. The instruction states that the impact of Sevelamer on the level of calcium and phosphorus in the blood is stored for one year after completion of the course.
Sevelamer provides greater efficiency in comparison with calcium, resulting in increasing overall survival rate by an average of 1.62 years per patient. The increase in overall survival in the target group of patients is critical because it determines the possibility of a kidney transplant, thereby significantly improving the quality of life of these patients. The simulation was just shown that the application of sevelamer possible to increase the number of transplants.
The use of sevelamer is more costly in comparison with calcium (22-25% difference). However, sevelamer therapy in accordance with the number of CPD is safer than the number of cardiovascular events as well less than with calcium. The use of sevelamer makes it possible to increase the number of transplantations twice (117%) while maintaining the life and increasing its quality. Moreover, the calculated maximum number of years prior to transplantation for one patient is increased by 10 years compared with calcium supplementation. In order to prolong the life of the patient by 1.62 years when switching from calcium salts to sevelamer one must spend approximately $300 extra.
To determine the comparative effectiveness of sevelamer and calcium supplements at different target levels transplants (5-25%) survival modeling is done every year, taking into account the cost of a kidney transplant and subsequent immunosuppressive therapy aimed at preventing graft rejection. Based on the cost parameters of a kidney transplant, reflected in the standards of high-tech medical care, $25,000 per transplantation and the cost of immunosuppressive therapy: treatment of acute rejection crisis - $3,000 and receiving drugs during the year $5,000 per patient, the total cost of one transplant will be $33,000 per transplantation. Sevelamer compared with calcium allows a greater proportion of patients with life-saving implement kidney transplant, whereby the use of sevelamer is more advantageous than calcium options.
Sevelamer use in patients with CRF correction hyperphosphataemia can achieve increased life expectancy of the patient to 1.62 years without kidney transplantation compared with calcium. Sevelamer increases the number of kidney transplants by 117% and the amount of added quality of life by 123% in comparison with calcium preparations. The use of sevelamer is more cost effective than calcium value because the use of sevelamer life priced less than calcium. The economic benefits of sevelamer are confirmed by including it int in the state (insurance) programs which deal with complex treatment of patients with chronic renal failure.
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