Economic Analysis of Cinacalcet in Combination With Low-Dose Vitamin D Versus Flexible-Dose Vitamin D in Treating Secondary Hyperparathyroidism in Hemodialysis Patients

Cinacalcet combined with vitamin D analogues was no more effective than vitamin D analogues in achieving the primary ACHIEVE end point and incurred greater costs. This conclusion was not tempered substantially by the cost of vitamin D analogues or oral phosphate binders. Whether the additional costs of cinacalcet are warranted will require longer term models to determine whether changes in serum levels of mineral metabolic markers translate into lower morbidity, mortality, and downstream costs.