Improved patient blood management and cost saving in hip replacement surgery through the implementation of pre-operative Sucrosomial® iron supplementation: a quality improvement assessment study

Scardino, Marco; Matteo, Berardo Di; Martorelli, Federica; Tanzi, Dario; Kon, Elizaveta; D'Amato, Tiziana

doi:10.1007/s00264-018-4149-7

Cited by 19 publications

(18 citation statements)

References 36 publications

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“…Our cost minimization analysis is based on the main clinical trial result, that is the demonstrated same efficacy of oral iron and IV iron. Sucrosomial iron has demonstrated a similar effectiveness, with lower costs, in patients usually receiving IV iron (e.g., chronic kidney disease, cancer, bariatric surgery) in several studies published recently [25][26][27][28]. In particular, Darbà et al [26] conducted a budget impact analysis of an oral sucrosomial iron in the treatment of patients similar with those of our study.…”

Section: Discussionsupporting

confidence: 82%

“…They conclude that increase in the use of oral sucrosomial iron leads to overall budget savings of €775,464 for the Spanish National Health Service over 4 years. A retrospective study [28] evaluated the efficacy of preoperative Sucrosomial iron in 200 paired-matched patients undergoing prosthetic hip surgery reports that Sucrosomial iron supplementation led to a quicker postsurgical recovery, shorter hospitalisation and decreased surgery-related costs with an estimated cost saving of 1763/patient.…”

Section: Discussionmentioning

confidence: 99%

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Oral Sucrosomial® iron versus intravenous iron for recovering iron deficiency anaemia in ND-CKD patients: a cost- minimization analysis

Riccio

Sabbatini²,

Capuano³

et al. 2020

BMC Nephrol

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Background: Oral iron is recommended as first line treatment of anemia in non-dialysis chronic kidney disease (ND-CKD) patients. Sucrosomial® iron, a new generation oral iron with high absorption and bioavailability and a low incidence of side effects, has shown to be not inferior to intravenous (IV) iron in the replacement of iron deficiency anemia in patients with ND-CKD. Besides the clinical benefit, it is also important to determine the comparative total costs of oral versus IV iron administrations. The aim of this study was to perform a cost-minimization analysis of oral Sucrosomial iron, compared with IV iron gluconate from an Italian societal perspective. Methods: Cost analysis was performed on the 99 patients with ND-CKD and iron-deficiency anemia of the randomized trial by Pisani et al. Human and material resources utilization was recorded during each iron administration. According to study perspective, direct and indirect costs were considered. Costs for each resource unit were taken from official Italian sources. Probabilistic sensitivity analyses were carried out to test the robustness of the results. Results: The base case analysis showed an average cost/cycle per patient of € 111 for oral iron and € 1302 for IV iron. Thus, the potential saving was equal to € 1191 per patient/cycle. The sensitivity analysis showed that the most sensitive driver is the time loss by patient and caregivers for the therapy and related-care, followed by the minutes of nursing care and the number of kilometres travelled to reach the referral centre. Discussion: This study showed that oral Sucrosomial® iron could offer specific advantages in terms of potential savings, and allowed identifying some implications for future research. Such advantages still persist with the new single dose IV iron formulation available in the market, although to a lesser extent.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Oral Sucrosomial® iron versus intravenous iron for recovering iron deficiency anaemia in ND-CKD patients: a cost- minimization analysis

Riccio

Sabbatini²,

Capuano³

et al. 2020

BMC Nephrol

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“…In elderly IDA patients, a 2-month course of 50 mg of elemental iron daily was as effective as 150 mg daily at improving Hb and ferritin but with fewer gastrointestinal side effects [23]. In primary hip replacement, a retrospective study showed that, compared to no iron supplementation, liposome-encapsulated ferric pyrophosphate iron (30 mg/day for 3–4 weeks preoperatively) was well tolerated, reduced transfusion requirements and length of hospital stay, and resulted in higher Hb levels 30 days after discharge [24]. …”

Section: Treatment Options For Iron Deficiencymentioning

confidence: 99%

Management of Perioperative Iron Deficiency Anemia

et al. 2019

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Preoperative anemia affects 30–40% of patients undergoing major surgery and is an independent risk factor for perioperative blood transfusion, morbidity, and mortality. Absolute or functional iron deficiency is its leading cause. Nonanemic hematinic deficiencies are also prevalent and may hamper preoperative hemoglobin optimization and/or recovery from postoperative anemia. As modifiable risk factors, anemia and hematinic deficiencies should be detected and corrected prior to major surgical procedures. Postoperative anemia is even more common (up to 80–90%) due to surgery-associated blood loss, inflammation-induced blunted erythropoiesis, and/or preexisting anemia. Preoperative oral iron may have a role in mild-to-moderate anemia, provided there is sufficient time (6–8 weeks) and adequate tolerance of oral preparations. Postoperative oral iron is of little value and rife with gastrointestinal adverse events. Intravenous iron should preferentially be used in cases of moderate-to-severe iron deficiency anemia, concomitant use of erythropoiesis-stimulating agents, short time to surgery or nonelective procedures, and for postoperative anemia management. Minor infusion reactions to intravenous iron are rare, the incidence of severe anaphylactic reactions is extremely low, and there is no increase in infections with intravenous iron. Currently available intravenous iron formulations allowing administration of large single doses are preferred.

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“…A retrospective study evaluated the efficacy of preoperative SI in 200 paired-matched patients undergoing prosthetic hip surgery (2106) in terms of blood transfusion requirements, length of hospital stay and postoperative Hb recovery [91]. Preoperative iron supplementation with SI (30 mg/day for 3–4 weeks, preoperatively) was offered to 100 patients with Hb 12–13.5 g/dL, for women, or 13–14 g/dL, for men, and ferritin < 100 ng/mL (ID) or ferritin > 100 ng/mL, if there was an elevated CRP or TSAT < 20% (FID).…”

Section: Sucrosomial® Iron For the Management Of Iron Deficiency Imentioning

confidence: 99%

Sucrosomial® Iron: A New Generation Iron for Improving Oral Supplementation

Gómez‐Ramírez

Brilli²,

Tarantino³

et al. 2018

Pharmaceuticals

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Iron deficiency (ID) is usually treated with oral iron salts, but up to 50% of patients complain of gastrointestinal side effects, leading to reduced compliance with treatment. Intravenous (IV) iron formulations are increasingly safe, but there is still a risk of infusion, hypersensitivity reactions and the need for venous access and infusion monitoring. Sucrosomial® Iron (SI) is an innovative oral iron formulation in which ferric pyrophosphate is protected by a phospholipid bilayer plus a sucrester matrix (sucrosome), which is absorbed through para-cellular and trans-cellular routes (M cells). This confers SI’s unique structural, physicochemical and pharmacokinetic characteristics, together with its high iron bioavailability and excellent gastrointestinal tolerance. The analysis of the available evidence supports oral SI iron as a valid option for ID treatment, which is more efficacious and tolerable than oral iron salts. SI has also demonstrated a similar effectiveness, with lower risks, in patients usually receiving IV iron (e.g., chronic kidney disease, cancer, bariatric surgery). Thus, oral SI emerges as a valuable first option for treating ID, especially for subjects with intolerance to iron salts or those for whom iron salts are inefficacious. Moreover, SI should also be considered as an alternative to IV iron for initial and/or maintenance treatment in different patient populations.

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Improved patient blood management and cost saving in hip replacement surgery through the implementation of pre-operative Sucrosomial® iron supplementation: a quality improvement assessment study

Cited by 19 publications

References 36 publications

Oral Sucrosomial® iron versus intravenous iron for recovering iron deficiency anaemia in ND-CKD patients: a cost- minimization analysis

Oral Sucrosomial® iron versus intravenous iron for recovering iron deficiency anaemia in ND-CKD patients: a cost- minimization analysis

Management of Perioperative Iron Deficiency Anemia

Sucrosomial® Iron: A New Generation Iron for Improving Oral Supplementation

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