Cost of Expensive Medication in Dialysis Catheters May Be Offset by Reduced Complications
Drug used to prevent clots lowers risk of hospitalization for catheter-related bacterial infections
Article ID: 620264
Released: 7-Jul-2014 3:00 PM EDT
Source Newsroom: American Society of Nephrology (ASN)
Highlights• The increased cost of an expensive drug that can prevent clots in dialysis catheters may be offset by lower costs for managing complications.• Additional studies are needed to determine the medication’s long-term cost and effectiveness.
In North America, approximately 80% of patients undergoing hemodialysis initiate treatment with a catheter.
Newswise — Washington, DC (July 10, 2014) — Using an expensive agent to prevent blood clots in kidney failure patients’ dialysis catheters may turn out to be less costly overall due to its ability to reduce medical complications, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN).
Recombinant tissue plasminogen activator (rt-PA) is a medication used to break up blood clots that occur in the vessels of patients having a heart attack. A recent clinical trial revealed that using rt-PA once per week plus the anticlotting agent heparin twice per week was better than using heparin alone 3 times per week for preventing blood clots and infections in dialysis catheters. Its significant expense has limited its use in many dialysis programs, however.
Braden Manns, MD, MSc (University of Calgary, in Alberta, Canada) and his colleagues collected detailed costs within this trial to determine how the use of rt-PA affected overall health care costs over time. The researchers found that the increased cost of rt-PA was partially offset by lower costs for managing complications. Overall, the difference in unadjusted average cost for managing patients with rt-PA/heparin versus heparin alone was $323 Canadian dollars. When the costs were extrapolated over a 1-year time horizon, assuming ongoing rt-PA effectiveness, the overall costs of the strategies in the trial were similar.
“Our study suggests that for patients at high risk of dialysis line blockage, a higher expense rt-PA may provide reasonable value for the money,” said Dr. Manns.
Study co-authors include Nairne Scott-Douglas, MD, PhD, Marcello Tonelli, MD, SM, Pietro Ravani, MD, PhD, Martine LeBlanc, MD, Marc Dorval, MD, MPH, MBA, Rachel Holden, MD, Louise Moist, MSc, MD, Charmaine Lok, BSc, FRCPC, MD, MSc, Deborah Zimmerman, MD, MSc, Flora Au, MSc, and Brenda Hemmelgarn, MD, PhD.
Disclosures: Braden Manns: investigator initiated research grant from Hoffman La RocheNairne Scott-Douglas: Research grants from Hoffman La Roche, Janssen Inc, Chief Medical, and Amgen; honorarium for lectures from Takeda, Hoffman La Roche, Chief MedicalMarcello Tonelli: Investigator-initiated research grants from Abbott and BaxterMarc Dorval: speaker/consultant fee and/or research funds from Amgen, Gambro, Baxter, Merck, NovartisRachel Holden: Investigator initiated research grant from AmgenLouise Moist: investigator initiated research grant from Hoffman La Roche; honorarium for lectures or advisory boards from Hoffman La RocheBrenda Hemmelgarn: investigator initiated research grant from Hoffman La Roche.
The article, entitled “An Economic Evaluation of rt-PA Locking Solution in Dialysis Catheters,” will appear online at http://jasn.asnjournals.org/ on July 10, 2014.
The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.Founded in 1966, and with more than 14,000 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.