← The record

Lanthanum Carbonate HydrateFosrenol Chewable Tablets

Recommended EndocrinologyRestricted

Management of hyperphosphataemia in patients with chronic kidney disease on dialysis whose serum phosphate is not controlled on other products and where serum phosphate is greater than 1.6 mmol per L or the serum calcium times phosphate product is greater than 4.0.

2
Submissions
1 resub
2007–08
On the record
$45k–75k
ICER range
1 sourced ICER · 2007
Cost-min
Cost basis

Decision on record

1 decision
  • Meeting Jul 2010 Recommended Binds phosphate in patients with end stage kidney disease. no PSD

Access path

2 submissions · public record
  1. TGA registered · Fosrenol Chewable Tablets

    TGA label narrower than the PBS population

  2. Mar 2007
    Not recommended

    uncertain efficacy of lanthanum versus calcium carbonate in phosphate control, lack of data linking treatment effects…

  3. ↻ resubmitted
    Nov 2008
    Recommended

    Comparator changed: calcium carbonate → sevelamer hydrochloride

  4. PBS listing · Restricted
RecommendedDeferredNot recommended

Cost-effectiveness

1 sourced ICER · 2007

Cost-minimisation analysis presented; no ICER calculated by design

The meta-analysis on which the dose relativity is based uses trials that are widely variable clinically, which made the calculation of equi-effective doses somewhat uncertain. PBAC · 2008
ICER uncertainEconomic model disputedIndirect comparison

Decision context

PopulationPatients with chronic kidney disease on dialysis whose serum phosphate is not controlled on other products and where serum phosphate is greater than 1.6 mmol per L or the serum calcium times phosphate product is greater than 4.0

Submission history

2 entries
DecidedOutcomeComparatorICEREvidence
Nov 2008 Recommended sevelamer hydrochloride RCT · Phosphate control
Mar 2007 Not recommended calcium carbonate $45k–75k RCT

Similar precedents

By decision profile

Regulatory · TGA

Label narrower than PBS population — PBAC restricts to patients with inadequate phosphate control on other products and specific biochemical thresholds (phosphate >1.6 mmol/L or calcium-phosphate product >4.0).