Etelcalcetide use decreased and mean parathyroid hormone (PTH) values increased after the January 2021 change in Medicare’s end-stage renal disease (ESRD) prospective payment system, investigators reported at the American Society of Nephrology’s Kidney Week 2022.

Since 2018, etelcalcetide has been separately reimbursed under the Transitional Drug Add-On Payment Adjustment. In January 2021, etelcalcetide use was incorporated into the bundle base rate based on a national average usage rate of 6.3% of dialysis treatments.

During the 2019-2020 period, 5105 of 34,924 patients on dialysis (14.2%) received etelcalcetide each month, Stuart M. Sprague of NorthShore University HealthSystem in Evanston, Illinois, and colleagues reported. After the January 2021 payment policy change, only 217 patients (0.7%) were receiving etelcalcetide each month. Mean monthly PTH values increased from 483 pg/mL before the policy change to 544 pg/mL after the policy change.

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Among the 3560 patients who discontinued etelcalcetide when the payment policy changed in January 2021, mean monthly PTH increased from 579 to 745 pg/mL.

Etelcalcetide use substantially decreased after the policy change, Dr Sprague’s team concluded. “Future studies are warranted to investigate the impact of the policy change on patient outcomes.”

Disclosure: This research was supported by Amgen. Please see the original reference for a full list of disclosures.


Moore C, Saleem N, Ma J, Mak GC, Martin KJ, Sprague SM. Change in payment method and the use of etelcalcetide and PTH values among dialysis patients in two dialysis organizations. Presented at: Kidney Week 2022; November 3-6, Orlando, Florida. Poster FR-PO535.