Background and Importance Iron carboxymaltose (ICM) and iron sucrose (IS) are two types of intravenous iron used for the treatment of iron-deficiency anaemia. Differences between the dosing regimen and hospital length have led many centres to perform cost-effectiveness studies with variable results.
Aim and Objectives To compare the effectiveness and cost of intravenous ICM vs IS for the control of anaemia in hospitalised patients.
Material and Methods Retrospective cohort study in anaemic patients (Hb≤12g/dL) who received ICM (500-1,000mg, single-dose) or IS (≥3 X 100mg) between April 2021 and April 2022 was performed. Demographic variables (age, gender), total dose administered, Hb pre and post-treatment (>6 days), patients with increased Hb≥1g/dl, previous treatment with oral iron, hospital admission length and direct cost were collected.
Cohorts were matched for baseline characteristics (age, gender and hospital service) and initial Hb values. Selected variables were compiled from the electronic medical history and prescription and compared using student's t test with SPSS v.22.0.
Results A total of 98 patients (63.3% women) were included: 49 received ICM and 40 IS. Mean age was 75.5 ± 13.8 and 75.9 ± 13.6 years for the ICM and IS groups respectively. In the ICM cohort, patients received a mean dose of 867.35 ± 223.0mg and 36.7% had previously received oral iron. Patients in the IS cohort received a mean dose of 438.8 ± 199.8mg and 22.4% had previously received oral iron.
The mean previous Hb was: 9.5 ± 1.4g/dl in the ICM group and 9.4 ± 1.3g/dl in the IS group. In the ICM group, 38.7% patients showed an increase Hb≥1g/dl, while 24.5% did so in the IS group. Statistically significant variations in Hb levels were observed in both groups (+0.71g/dl in ICM vs +0.31g/dl in IS; p<0.05). However, the analysis showed no significant differences between both cohorts (p=0.06).
Hospital duration length mean was shorter in the IS group (15.3 ± 21.9 vs 19.9 ± 22,9 days) without significant differences between cohorts (p=0.307). A mean cost of 144.2 ± 37.1€/patient and 5.0 ± 2.3€/patient was estimated for the ICM and IS groups respectively.
Conclusion and Relevance ICM and IS administration produced an improvement of Hb levels in both cohorts without showing a significant difference in the hospital admission length. ICM treatment entailed an increase of direct costs.
Conflict of Interest No conflict of interest
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