SAT-204 PATIROMER AND HEALTHCARE RESOURCE UTILIZATION IN THE REAL-WORLD SETTING

Abstract

Patiromer is a sodium-free, non-absorbed, potassium (K+) binder approved for the treatment of hyperkalemia (HK). This study aimed to evaluate healthcare resource utilization (HRU) before and after K+ binder initiation or HK diagnosis in a real-world setting. Patients initiating patiromer (PAT), sodium polystyrene sulfonate (SPS), and those with HK but not exposed to a K+ binder (NoKb) were identified in a large, de-identified national health insurance claims database, Optum® Clinformatics® Datamart, during a two-year study period (1/1/16 to 12/31/17). The index date was the date of the 1st K+ binder dispensing or 1st HK diagnosis. All patients had a pre-index serum K+ ≥5.0 mEq/L. During follow-up, PAT and SPS patients were continuously exposed to their respective K+ binder - NoKb patients did not initiate a K+ binder. Study outcomes included: the 6 months pre-index vs. 6 months post-index difference in the % of patients with a hospitalization or emergency department (ED) visit. Pre- vs. post-index % change was analyzed using McNemar’s statistical test for paired nominal data. A study population of 610 PAT patients, 5556 SPS patients, and 21282 NoKb patients were included. At 6 months post-index, 106 PAT patients, 69 SPS patients, and 12596 NoKb patients remained continuously exposed and uncensored. Overall, the mean age was 75 and 51% were male. Patient comorbidities (all cohorts): CKD (48%), ESRD (3%), CHF (23%), and DM (47%). PAT was associated with a statistically significant reduction (p<0.05) in % of patient admissions and ED visits (Figure). SPS was associated with a non-significant reduction in % of patient admissions and no change in ED visits. In contrast, NoKb was associated with significant increases in % of patient admissions and ED visits (p<0.001). This is a descriptive observational study and therefore no causal or comparative claims can be derived. K+ binder cohorts have a small sample size compared to the NoKb cohort. Following continuous exposure, patients receiving patiromer were the least likely to be admitted or visit the ED. Additional studies are needed to further elucidate these findings.