← The record

Sevelamer HydrochlorideRenagel

Recommended EndocrinologyAuthority Required

Treatment of hyperphosphataemia in adult patients with chronic kidney disease on dialysis whose serum phosphate is not controlled on other products.

6
Submissions
5 resub
2006–07
On the record
$15k–105k
ICER range
6 sourced ICERs · 2006–2007
ICER stated
Cost basis

Decisions on record

6 decisions
  • Meeting Jul 2010 Recommended Binds phosphate in patients with end stage kidney disease no PSD
  • Meeting Jul 2009 Not recommended Hyperphosphataemia no PSD
  • Meeting Jul 2008 Recommended Chronic kidney disease no PSD
  • Meeting Mar 2008 Recommended Chronic kidney disease no PSD
  • Meeting Nov 2007 Recommended Kidney disease no PSD
  • Meeting Jul 2007 Recommended Hyperphosphataemia

Access path

6 submissions · public record
  1. TGA registered · Renagel

    TGA label narrower than the PBS population

  2. Mar 2006
    Recommended

    Comparator changed: calcium-based phosphate binders → calcium-based phosphate binders…

  3. Mar 2006
    Recommended

    Comparator changed: calcium-based phosphate binders → calcium-based phosphate binders…

  4. Nov 2006
    Not recommended

    uncertain clinical benefit (mortality results relied on pre-specified subgroup analysis with non-significant primary…

  5. Nov 2006
    Not recommended

    uncertain clinical benefit due to doubts about validity of mortality results in DCOR (reliance on pre-specified…

  6. ↻ resubmitted
    Jul 2007
    Recommended · restricted
  7. Jul 2007
    Recommended · restricted
  8. PBS listing · Authority Required
RecommendedDeferredNot recommended

Cost-effectiveness

6 sourced ICERs · 2006–2007
The estimated incremental cost-effectiveness ratios per life year gained are in the range $15,000 – $45,000 based on the DCOR trial 65 and older population and RIND trials. PBAC · 2007
ICER uncertain ×2ICER / price too high ×2Economic model disputed

Decision context

PopulationAdults with chronic kidney disease on dialysis whose serum phosphate is not controlled on other products, with serum phosphate >1.6 mmol/L or serum calcium times phosphate product >4.0.

Submission history

6 entries
DecidedOutcomeComparatorICEREvidence
Jul 2007 Recommended · restricted calcium carbonate $15k–45k RCT
Jul 2007 Recommended · restricted calcium carbonate $15k–45k RCT
Nov 2006 Not recommended calcium carbonate $15k–75k RCT | Other · Other
Nov 2006 Not recommended calcium carbonate $15k–45k RCT · CAC
Mar 2006 Recommended calcium-based phosphate binders $45k–105k RCT
Mar 2006 Recommended calcium-based phosphate binders (calcium carbonate and calcium citrate) $45k–105k RCT · OS

Similar precedents

By decision profile

Regulatory · TGA

Label narrower than PBS population — PBAC restricts to dialysis patients with uncontrolled phosphate despite other products; TGA label includes all stage 4–5 CKD patients.