title: Cost-minimization analysis favours intravenous ferric carboxymaltose over ferric sucrose for the ambulatory treatment of severe iron deficiency.
abstract: OBJECTIVE
  Intravenous 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.
  
  
  METHODS
  The 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.
  
  
  RESULTS
  Under 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.
  
  
  CONCLUSIONS
  In this pharmacoeconomic analysis, FCM infusion reduced the costs of iron infusion at a gastrointestinal day-care unit.
authors.affiliation: Servei Aparell Digestiu, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain. xcalvet@tauli.cat
authors.forename: Xavier
authors.initials: X
authors.lastname: Calvet
authors.forename: Miquel Àngel
authors.initials: MÀ
authors.lastname: Ruíz
authors.forename: Angelina
authors.initials: A
authors.lastname: Dosal
authors.forename: Laura
authors.initials: L
authors.lastname: Moreno
authors.forename: Maria
authors.initials: M
authors.lastname: López
authors.forename: Ariadna
authors.initials: A
authors.lastname: Figuerola
authors.forename: David
authors.initials: D
authors.lastname: Suarez
authors.forename: Mireia
authors.initials: M
authors.lastname: Miquel
authors.forename: Albert
authors.initials: A
authors.lastname: Villoria
authors.forename: Emili
authors.initials: E
authors.lastname: Gené
mesh_terms: D000553:Ambulatory Care; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy*; D003365:Costs and Cost Analysis; D005290:Ferric Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008320:Maltose / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009010:Monte Carlo Method; D012189:Retrospective Studies; D013395:Sucrose / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D005290:Ferric Compounds; D013395:Sucrose; C522335:ferric carboxymaltose; D008320:Maltose