Zirconium Cyclosilicate: where the agencies disagree
This page collects every recorded health technology assessment decision for one molecule across the agencies in our archive, and compares them. The comparison is the point: each agency publishes its own verdict, none publishes how that verdict sits against the others.
What the record shows
PBAC (Australia), SMC (Scotland) and TLV (Sweden) recommended or restricted zirconium cyclosilicate, while AOTMIT (Poland) did not recommend it.
Where zirconium cyclosilicate met resistance it was usually narrowed rather than refused: 3 of 6 decisive outcomes were recommendations with restrictions, against 1 outright refusal.
Assessment has run over 8.2 years, from 5 Jun 2018 at AWMSG (Wales) to 10 Aug 2026 at SMC (Scotland).
No assessment is on file from HAS (France), PHARMAC (New Zealand), CIPM (Spain) and G-BA (Germany), each among the eight highest-volume agencies here.
The file is active: 5 of 8 records date from 2023 or later.
4 distinct indication wordings are recorded for zirconium cyclosilicate by the agencies that label one in English (AWMSG, NICE, PBAC and SMC).
2 of these 8 records carry a year of decision but no day, so any interval quoted here is approximate to within a year.
AWMSG (Wales) was first to assess zirconium cyclosilicate, on 5 Jun 2018; AOTMIT (Poland) did not open a file until 7 May 2026 — a wide spread of 7.9 years between the earliest and latest system to look at it.
Activity is concentrated rather than steady: 4 of 8 dated records fall in 2026 alone.
Restriction is doing real work here: 3 of 6 decisive outcomes narrowed zirconium cyclosilicate to a subgroup rather than accepting or refusing it outright, at SMC (Scotland) and TLV (Sweden).
2 of the 6 agencies here assessed zirconium cyclosilicate more than once, SMC (Scotland) most often at 2 entries — repeat review is the norm for this molecule rather than the exception.
6 of the 18 agencies in this archive hold a record for zirconium cyclosilicate.
The full ledger for zirconium cyclosilicate reads 3 restricted, 2 recommended, 1 not recommended and 1 appraised, with 1 in other categories.
Decisions on file
| Agency | Date | Indication as recorded | Outcome | Source |
|---|---|---|---|---|
| PBAC (Australia) | 2026 | Hyperkalaemia in patients with chronic kidney disease | In March 2026, the PBAC extended its March 2024 recommendation for this drug for a further… | source |
| AOTMIT (Poland) | 7 May 2026 | Lokelma reimbursement recommendation | not recommended | source |
| NICE (England) | 29 Apr 2026 | NICE TA1148 | published appraisal | source |
| SMC (Scotland) | 7 Sep 2020 | For the treatment of hyperkalaemia (HK) in adult patients. | accepted (restricted) | source |
| TLV (Sweden) | 25 Jan 2019 | Lokelma ingår i högkostnadsskyddet med begränsning | restricted subsidy | source |
3 further decisions for zirconium cyclosilicate, across 3 agencies, are not shown here. They include the most recent record on file, 10 Aug 2026 from SMC (Scotland); its outcome is in the subscriber dataset. They link to 2 further source documents.
Related molecules
- sevelamer — same ATC class V03A — Other therapeutic products
- deferasirox — same ATC class V03A — Other therapeutic products
- patiromer — same ATC class V03A — Other therapeutic products
- deferiprone — same ATC class V03A — Other therapeutic products
- difelikefalin — same ATC class V03A — Other therapeutic products
- naloxone — same ATC class V03A — Other therapeutic products
Coverage: 8 decisions for zirconium cyclosilicate from 6 agencies, 2018 to 2026. Data to 7 Sep 2026. ATC class V03A — Other therapeutic products. How this page is produced. Compiled by Altima Partners; queries: sales@altimapartners.co.uk.