Objective To evaluate the cost-effectiveness of lanthanum carbonate versus sevelamer in the treatment of hyperphosphatemia among maintenance hemodialysis patients from the perspective of the Chinese healthcare system under the context of centralized procurement.

Methods Based on the published Markov model research, combined with the post-procurement drug prices, epidemiological data and medical costs in China, a 15-year Markov model was constructed. The model included four health states: "no cardiovascular and cerebrovascular diseases", "with cardiovascular and cerebrovascular diseases", "death from cardiovascular and cerebrovascular diseases" and "death from non-cardiovascular and cerebrovascular diseases". The model parameters were derived from published clinical studies, the Chinese Health Statistical Yearbook and local medical cost data. The main output indicator was the incremental cost-utility ratio. Single-factor and probabilistic sensitivity analyses were conducted to verify the robustness of the results.

Results The total cost of Sviram was higher than that of lanthanum carbonate (P ＜ 0.05), and its cost-effectiveness ratio was also higher than that of lanthanum carbonate (P ＜ 0.05). Lanthanum carbonate treatment can achieve more quality-adjusted life years, with an incremental cost-utility ratio of 43344 yuan/QALY. Lanthanum carbonate was economically viable.

Conclusions Under the context of substantial price reductions for lanthanum carbonate due to centralized procurement, lanthanum carbonate is a cost-effective treatment option for hyperphosphatemia in hemodialysis patients compared to sevelamer.