The treatment of secondary hyperparathyroidism (SHPT) in patients with chronic kidney disease (CKD) is generating high costs worldwide mainly due to adverse complications. In Ecuador, only few healthcare institutions have implemented management protocols for the treatment of SHPT to reduce costs and to improve patient quality of life. The goal of this study was to evaluate the short (1 year) and long-term (5 years) costs and savings in the management of SHPT with calcitriol and paricalcitol in CKD patients.