Cost-Minimization Analysis Favours Intravenous Ferric Carboxymaltose over Ferric Sucrose for the Ambulatory Treatment of Severe Iron Deficiency

Abstract

ObjectiveIntravenous iron is widely used to treat iron deficiency in day-care units. Ferric carboxymaltose (FCM) allows administration of larger iron doses than iron sucrose (IS) in each infusion (1000 mg vs. 200 mg). As FCM reduces the number of infusions required but is more expensive, we performed a cost-minimization analysis to compare the cost impact of the two drugs.Materials and MethodsThe number of infusions and the iron dose of 111 consecutive patients who received intravenous iron at a gastrointestinal diseases day-care unit from 8/2007 to 7/2008 were retrospectively obtained. Costs of intravenous iron drugs were obtained from the Spanish regulatory agencies. The accounting department of the Hospital determined hospital direct and indirect costs for outpatient iron infusion. Non-hospital direct costs were calculated on the basis of patient interviews. In the pharmacoeconomic model, base case mean costs per patient were calculated for administering 1000 mg of iron per infusion using FCM or 200 mg using IS. Sensitivity analysis and Monte Carlo simulation were performed.ResultsUnder baseline assumptions, the estimated cost of iron infusion per patient and year was €304 for IS and €274 for FCM, a difference of €30 in favour of FCM. Adding non-hospital direct costs to the model increased the difference to €67 (€354 for IS vs. €287 for FCM). A Monte Carlo simulation taking into account non-hospital direct costs favoured the use of FCM in 97% of simulations.ConclusionIn this pharmacoeconomic analysis, FCM infusion reduced the costs of iron infusion at a gastrointestinal day-care unit.

Comparative study of efficacy and safety of intravenous ferric carboxy maltose versus iron sucrose in treatment of postpartum iron deficiency anemia

“…Also use of high doses reduces the number of infusions, enabling the possibility of cost reductions compared to multiple administrations. [15][16][17][18] …”

Modern iron replacement therapy: clinical and pathophysiological insights

“…up to 7-10 infusions on consecutive days with ferric gluconate. The increasing costs per vial appear counterbalanced by reduced costs in terms of personnel, and in-hospital organization [110]. Moreover, the higher stability also results in a very good safety profile because of reduced probability to release of free iron.…”

A Cost-effectiveness Analysis of Ferric Carboxymaltose in Patients With Iron Deficiency and Chronic Heart Failure in Spain

“…The cost of FCM intravenous infusion in the day hospital, defined as 15 min infusion time, 15 min nursing time, and the cost of disposable equipment, was taken from a recent Spanish study. 14 The laboratory sale price of FCM 100 mg was taken from the database of the Consejo General de Colegios Oficiales de Farmace´uticos (Council of Official Colleges of Pharmacists), Bot PLUS 2.0 15 ( Table 2).…”