GVS assessment of sodium zirconium cyclosilicate (Lokelma®) for the treatment of hyperkalemia

Zorginstituut Nederland has completed its assessment whether sodium zirconium cyclosilicate (Lokelma®) is interchangeable with a product that has been included in the Medication Reimbursement System (GVS). The Zorginstituut's advice is to include sodium zirconium cyclosilicate (Lokelma®) on List 1A of the GVS in a newly formed cluster, together with sodium polystyrene sulphonate (SPS).

Registered indication

Sodium zirconium cyclosilicate (Lokelma®) is registered for the treatment of hyperkalemia in adults. Sodium zirconium cyclosilicate is available as a powder for oral suspension. Each sachet contains 5 g or 10 g.

Assessment

The usual pharmaco-therapeutic treatment that sodium zirconium cyclosilicate (Lokelma®) can be compared to consists of the resin preparations sodium polystyrene sulphonate (SPS, Resonium®) and calcium polystyrene sulphonate (CPS, Sorbisterit®). In addition, since 2019, the cation-exchange polymer patiromer (Veltassa®) has been included in the GVS.

Given that the effect of sodium zirconium cyclosilicate, like SPS, is based on the exchange of potassium with sodium, the present classification in the GVS means that SPS is considered to be comparable to sodium zirconium cyclosilicate. The Zorginstituut has concluded that sodium zirconium cyclosilicate has an equal value compared to sodium polystyrene sulphonate (SPS).

Zorginstituut's advice

Based on the considerations mentioned in the report, the Zorginstituut advises the Minister for Medical Care to include include sodium zirconium cyclosilicate (Lokelma®), together with sodium polystyrene sulphonate (SPS), on List 1A of the GVS in a newly formed cluster. The standard dose for sodium zirconium cyclosilicate can be set at 7.5 g per day. The standard dose for SPS is 45 g per day.

This report is a summary of recommendations by Zorginstituut Nederland. The original text is in Dutch.