Phosphorus binding with ferric citrate is associated with fewer hospitalizations and reduced hospitalization costs

Abstract

Background: Ferric citrate (FC) is a new phosphorus binder shown to increase serum iron stores while reducing intravenous iron and erythropoiesis-stimulating agent usage. Such reductions could lower hospitalization rates and associated costs.

Methods: Hospitalizations during a Phase III trial were compared between FC and active control (AC). Hospitalization costs were estimated using the 2013 US Renal Data System Annual Data Report.

Results: 34.6% of FC patients were hospitalized at least once versus 45.6% of the AC group (risk reduction 24.2%; p = 0.02). There were 181 unique hospitalizations in the FC group versus 239 in the AC group, for a difference of 58 hospitalizations. Total potential savings was US$ 867,622 in hospitalization costs in the FC group. If the hospitalization reduction in our study was applied to the general end-stage renal disease population, this could translate into a savings of US$ 3002/patient/year.

Conclusions: Patients receiving FC experienced fewer hospitalizations with the potential for significant savings.

Keywords: costs; dialysis; end-stage renal disease; erythropoiesis-stimulating agent; ferric citrate; hospitalization; iron.