Control of hyperphosphataemia in end-stage renal disease (ESRD) patients receiving maintenance dialysis is clinically important. Sucroferric oxyhydroxide (PA21) is a new calcium-free polynuclear iron(III)-oxyhydroxide phosphate binder with a high phosphate binding capacity.

In patients receiving maintenance dialysis intolerant of calcium-based phosphate binders, compared with sevelamer carbonate treatment PA21 appears to be cost saving and appears to yield only very limited disadvantages in terms of quality-adjusted survival from the perspective of the Scottish National Health Service.

Due to lack of data, certain assumptions had to be made. Future studies are needed to provide evidence of long-term outcomes.