Italian investigators probing etelcalcetide vs cinacalcet treatment adherence found higher adherence and lower potential costs with etelcalcetide.

Valentina Perrone, MD, of CliCon S.r.l. Società Benefit, Health, Economics & Outcomes Research, Bologna, Italy, and colleagues compared medication adherence between 1752 new users of oral cinacalcet and 527 new users of intravenous etelcalcetide receiving maintenance hemodialysis. To balance the cohorts, the investigators applied propensity score matching that took into account patient age, sex, prevalence of treatment with cinacalcet, Charlson Comorbidity Index, diabetes mellitus, hypertension, cardiovascular disease, fracture, tumors, and use of supplements and medications (ie, calcium, phosphate binders, vitamin D, erythropoiesis-stimulating agent, steroids, and osteoporosis drugs).

In covariate-balanced cohorts, medication adherence and persistence rates were significantly higher in the etelcalcetide (80.1% and 62.7%, respectively) than cinacalcet group (62.3% and 54.7%, respectively), the investigators reported in Healthcare.

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Disease-specific drug costs were significantly higher for cinacalcet than etelcalcetide users (EUR 2629 vs EUR 2355). Disease-specific hospitalization costs also were higher for cinacalcet (EUR 1241 vs EUR 855).

“The results showed that etelcalcetide-treated patients, with respect to the cinacalcet-treated cohort, were characterized by a higher rate of treatment persistence and adherence and cost restraints, especially those related to hospitalization and disease-specific medications, which could translate into an increase in cost savings for the Italian [National Health Service],” Dr Perrone’s team stated.

The route of drug administration may explain some results. Other research suggests that etecalcetide’s intravenous administration is preferable to orally administered cinacalcet in patients on dialysis, who have a high pill burden.


Perrone V, Dovizio M, Veronesi C, et al. Real-world evaluation of calcimimetics for the treatment of secondary hyperparathyroidism in chronic kidney disease, in an Italian clinical setting. Healthcare 10(4):709. Published online April 11, 2022. doi:10.3390/healthcare10040709