Cost-minimization analysis favours intravenous ferric carboxymaltose over ferric sucrose or oral iron as preoperative treatment in patients with colon cancer and iron deficiency anaemia

Calvet, Xavier; Gené, Emili; ÀngelRuíz, Miquel; Figuerola, Ariadna; Villòria, Albert; Cucala, Mercedes; Mearin, Fermı́n; Delgado, Salvadora; Calleja, José Luís

doi:10.3233/thc-151074

Cited by 29 publications

(14 citation statements)

References 24 publications

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“…A cost minimization analysis of patients scheduled for surgery for colorectal cancer, demonstrated that the use of FCM before surgery reduces direct and indirect costs of hospitalization compared to the use of saccharate iron and oral iron 29 . This cost savings can be explained by the reduced need for transfusion and hospitalization time; the preoperative use of FCM was shown in another study of anemic patients in a similar scenario 30 …”

Section: Intravenous Iron Is Preferred In the Treatment Of Cancer Patmentioning

confidence: 94%

Iron deficiency in cancer patients

Naoum

2016

Revista Brasileira de Hematologia e Hemoterapia

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Anemia is a frequent complication in cancer patients, both at diagnosis and during treatment, with a multifactorial etiology in most cases. Iron deficiency is among the most common causes of anemia in this setting and can develop in nearly half of patients with solid tumors and hematologic malignancies. Surprisingly, this fact is usually neglected by the attending physician in a way that proper and prompt investigation of the iron status is either not performed or postponed. In cancer patients, functional iron deficiency is the predominant mechanism, in which iron availability is reduced due to disease or the therapy-related inflammatory process. Hence, serum ferritin is not reliable in detecting iron deficiency in this setting, whereas transferrin saturation seems more appropriate for this purpose. Besides, lack of bioavailable iron can be further worsened by the use of erythropoiesis stimulating agents that increase iron utilization in the bone marrow. Iron deficiency can cause anemia or worsen pre-existing anemia, leading to a decline in performance status and adherence to treatment, with possible implications in clinical outcome. Due to its frequency and importance, treatment of this condition is already recommended in many specialty guidelines and should be performed preferably with intravenous iron. The evidences regarding the efficacy of this treatment are solid, with response gain when combined with erythropoiesis stimulating agents and significant increments in hemoglobin as monotherapy. Among intravenous iron formulations, slow release preparations present more favorable pharmacological characteristics and efficacy in cancer patients.

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Section: Intravenous Iron Is Preferred In the Treatment Of Cancer Patmentioning

confidence: 94%

Iron deficiency in cancer patients

Naoum

2016

Revista Brasileira de Hematologia e Hemoterapia

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“…Calvet et al. compared the cost implications of ferric carboxymaltose vs. iron sucrose vs. oral iron for avoiding red cell transfusion in 282 patients with colorectal cancer and anaemia, using cost‐minimisation analysis. Direct and indirect costs for acquisition and administration of iron product and RBC concentrates, as well as hospitalisation costs, were included in the cost model.…”

Section: Cost Implications Of Iron Therapymentioning

confidence: 99%

“…fewer hospital visits, less time off work) and the health system (e.g. less visits to day hospital, less ambulance transfers, less total cost) .…”

Section: Cost Implications Of Iron Therapymentioning

confidence: 99%

International consensus statement on the peri‐operative management of anaemia and iron deficiency

et al. 2016

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SummaryDespite current recommendations on the management of pre-operative anaemia, there is no pragmatic guidance for the diagnosis and management of anaemia and iron deficiency in surgical patients. A number of experienced researchers and clinicians took part in an expert workshop and developed the following consensus statement. After presentation of our own research data and local policies and procedures, appropriate relevant literature was reviewed and discussed. We developed a series of best-practice and evidence-based statements to advise on patient care with respect to anaemia and iron deficiency in the peri-operative period. These statements include: a diagnostic approach for anaemia and iron deficiency in surgical patients; identification of patients appropriate for treatment; and advice on practical management and follow-up. We urge anaesthetists and peri-operative physicians to embrace these recommendations, and hospital administrators to enable implementation of these concepts by allocating adequate resources.

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“…Till now, only few studies conducted cost‐benefit analysis of single measures including material and personnel costs. Calvet and colleagues, for example, compared cost implication of different iron strategies including costs of iron infusion, transfusion and hospitalization and found cost savings of €274 per patient for ferric carboxymaltose compared to oral iron . Cell salvage is indicated in patients with an expected blood loss of 500 ml or more.…”

Section: Discussionmentioning

confidence: 99%

Health economics of Patient Blood Management: a cost‐benefit analysis based on a meta‐analysis

et al. 2019

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Background and Objectives Patient Blood Management (PBM) is the timely application of evidence‐based medical and surgical concepts designed to improve haemoglobin concentration, optimize haemostasis and minimize blood loss in an effort to improve patient outcomes. The focus of this cost‐benefit analysis is to analyse the economic benefit of widespread implementation of a multimodal PBM programme. Materials and Methods Based on a recent meta‐analysis including 17 studies (>235 000 patients) comparing PBM with control care and data from the University Hospital Frankfurt, a cost‐benefit analysis was performed. Outcome data were red blood cell (RBC) transfusion rate, number of transfused RBC units, and length of hospital stay (LOS). Costs were considered for the following three PBM interventions as examples: anaemia management including therapy of iron deficiency, use of cell salvage and tranexamic acid. For sensitivity analysis, a Monte Carlo simulation was performed. Results Iron supplementation was applied in 3·1%, cell salvage in 65% and tranexamic acid in 89% of the PBM patients. In total, applying these three PBM interventions costs €129·04 per patient. However, PBM was associated with a reduction in transfusion rate, transfused RBC units per patient, and LOS which yielded to mean savings of €150·64 per patient. Thus, the overall benefit of PBM implementation was €21·60 per patient. In the Monte Carlo simulation, the cost savings on the outcome side exceeded the PBM costs in approximately 2/3 of all repetitions and the total benefit was €1 878 000 in 100·000 simulated patients. Conclusion Resources to implement a multimodal PBM concept optimizing patient care and safety can be cost‐effectively.

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Cost-minimization analysis favours intravenous ferric carboxymaltose over ferric sucrose or oral iron as preoperative treatment in patients with colon cancer and iron deficiency anaemia

Cited by 29 publications

References 24 publications

Iron deficiency in cancer patients

Iron deficiency in cancer patients

International consensus statement on the peri‐operative management of anaemia and iron deficiency

Health economics of Patient Blood Management: a cost‐benefit analysis based on a meta‐analysis

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