SUN-864 - Cost Effectiveness and Efficacy of Cinacalcet in Patients with Hypercalcaemia

Introduction: Cinacalcet is a highly effective agent for controlling hypercalcaemia in patients
with parathyroid carcinoma, secondary hyperparathyroidism on dialysis or primary
hyperparathyroidism (PHPT) who cannot undergo parathyroidectomy surgery due to
comorbidities and risk of anaesthesia.
Symptoms of hypercalcaemia include lethargy, confusion, constipations, renal stones,
depression, osteoporosis leading increased risk of fractures. These complications can lead to
hospital admissions.
Cinacalcet works as a calcimimetic by increasing the sensitivity of the calcium-sensing
receptor on parathyroid gland cells to extracellular calcium leading to inhibition of
parathyroid hormone (PTH) secretion, thus lowering serum calcium levels.

Aim: Looking at management of hypercalcaemia with cinacalcet and the cost effectiveness
and efficacy on the NHS.

Method:
Retrospective single-centre study looking at patients started on cinacalcet for
hypercalcaemia and their response to treatment and comparing cost effectiveness in the
NHS.
19 patients were identified at Queen’s Hospital, London, UK (BHRUT–Barking, Havering and
Redbridge University Hospitals NHS Trust) in 2025.

Results:
19 patients were identified as being started on cinacalcet for hypercalcaemia.
63% were female
Majority of the patients were in the age group 71-80 years old (37%) then followed by over
80 years of age at 26%
100% had serum calcium levels reduced after starting cinacalcet.
In total there were 18 hospital admission for these 19 patients. Research has showed that
the average cost of admission in the NHS cost approximately £500. Therefore, this is
equivalent to approximately £9000. However, the longer the hospital stay the more it would
cost. The average cost of cinacalcet 30mg, 28 tablets pack on the NHS is £5.08.
5 patients eventually underwent parathyroidectomy surgery

Conclusion:
Hypercalcaemia can be treated with cinacalcet to maintain serum calcium levels and avoid
complications and admissions to hospital. The implications of not diagnosing and treating
hypercalcaemia in timely manner with cinacalcet can result in more complications in
patients that may lead to multiple hospital admissions costing the NHS more money. 1 year
supply of 30mg cinacalcet once daily can cost approximately £60.96 under the NHS
compared to an average hospital admission costing £500. Our study showed that using
cinacalcet to manage hypercalcaemia is cost effective and has good efficacy for treating
hypercalcaemia in the NHS by reducing complications, need for surgery and avoiding multiple
hospital admissions.

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