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

Abstract

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.

Iron Therapy in Inflammatory Bowel Disease

“…It is a preparation of ferric pyrophosphate transported within a phospholipid and sucrose esters of fatty acid membrane. Due to its lack of direct contact with the intestinal mucosa, there has been a low report of side effects [ 39 ]. It also requires a lower drug dose than the ferrous variants [ 40 ].…”

Oral sucrosomial iron improves exercise capacity and quality of life in heart failure with reduced ejection fraction and iron deficiency: a non‐randomized, open‐label, proof‐of‐concept study

“…As a result, compared to conventional oral iron salts, SI provides enhanced bioavailability with excellent gastrointestinal tolerability 5 . Oral SI has been shown to be effective and well tolerated in patients with ID associated with several conditions such as chronic renal disease, cancer, gastrointestinal disease, pulmonary arterial hypertension, gestation, orthopaedic or bariatric surgery, or in support of erythropoietin‐stimulating agent therapy 5,7,8,13–15 . We similarly observed a significant change in serum iron, serum ferritin and haemoglobin levels in favour of SI, despite the fact that the daily elemental iron dose was low (28 mg), being that of dietary supplementation rather than therapy, owing to the excellent bioavailability of the molecule.…”

“…All patients were on optimal guideline‐directed HF therapy that had been stable for at least 4 weeks prior to enrolment. Twenty‐five patients consecutive patients fulfilling the above criteria were treated with oral SI (one capsule daily containing 28 mg of SI and 70 mg of ascorbic acid, Sideral Forte®, WinMedica, Athens, Greece) for 3 months, based on the design of previous studies 7,8 . Another group of 25 patients, also fulfilling the above criteria, matched for age, gender and HF severity [New York Heart Association (NYHA) class and LVEF], not treated with iron supplementation, served as controls.…”

Iron deficiency anemia – new possibilities of iron supplementation in various clinical conditions

“…Campanella and coauthors had similar observations for IDA patients, as SRM was shown to be effective and well-tolerated in situations where parenteral therapy was indicated [45]. Some authors indicate the economic benefits of sucrosomial iron, especially when compared to parenteral therapy [42,46]. However, most studies have been carried out in small groups of patients [50].…”