title: Cost-minimization analysis favours intravenous ferric carboxymaltose over ferric sucrose or oral iron as preoperative treatment in patients with colon cancer and iron deficiency anaemia.
abstract: BACKGROUND
  Ferric Carboxymaltose (FCM), Iron Sucrose (IS) and Oral Iron (OI) are alternative treatments for preoperative anaemia.
  
  
  OBJECTIVE
  To compare the cost implications, using a cost-minimization analysis, of three alternatives: FCM vs. IS vs. OI for treating iron-deficient anaemia before surgery in patients with colon cancer.
  
  
  METHODS
  Data from 282 patients with colorectal cancer and anaemia were obtained from a previous study. One hundred and eleven received FCS, 16 IS and 155 OI. Costs of intravenous iron drugs were obtained from the Spanish Regulatory Agency. Direct and indirect costs were obtained from the analytical accounting unit of the Hospital. In the base case mean costs per patient were calculated. Sensitivity analysis and probabilistic Monte Carlo simulation were performed.
  
  
  RESULTS
  Total costs per patient were 1827® in the FCM group, 2312® in the IS group and 2101® in the OI group. Cost savings per patient for FCM treatment were 485® compared to IS and 274® compared to OI. A Monte Carlo simulation favoured the use of FCM in 84.7% and 84.4% of simulations when compared to IS and OI, respectively.
  
  
  CONCLUSIONS
  FCM infusion before surgery reduced costs in patients with colon cancer and iron-deficiency anaemia when compared with OI and IS.
authors.affiliation: Servei Aparell Digestiu, Corporació Sanitària Universitària Parc Taulí, Sabadell, Spain.|CIBERehd, Instituto de Salud Carlos III, Spain.|Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Calvet
authors.affiliation: CIBERehd, Instituto de Salud Carlos III, Spain.|Servei d'Urgències, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, Spain.|Departament de Medicina, Universitat Internacional de Catalunya, Spain.
authors.forename: Emili
authors.initials: E
authors.lastname: Gené
authors.affiliation: Departament de Comptabilitat Analítica, Corporació Sanitària i Universitària Parc Taulí, Sabadell, Barcelona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: ÀngelRuíz
authors.affiliation: Servei Aparell Digestiu, Corporació Sanitària Universitària Parc Taulí, Sabadell, Spain.|CIBERehd, Instituto de Salud Carlos III, Spain.
authors.forename: Ariadna
authors.initials: A
authors.lastname: Figuerola
authors.affiliation: Servei Aparell Digestiu, Corporació Sanitària Universitària Parc Taulí, Sabadell, Spain.|CIBERehd, Instituto de Salud Carlos III, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Villoria
authors.affiliation: Medical Department, Vifor Pharma España, Barcelona, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Cucala
authors.affiliation: Gastroenterology Department, Centro Médico Teknon, Barcelona, Spain.
authors.forename: Fermín
authors.initials: F
authors.lastname: Mearin
authors.affiliation: Gastrointestinal Surgery Department, Hospital Clinic de Barcelona, Barcelona, Spain.
authors.forename: Salvadora
authors.initials: S
authors.lastname: Delgado
authors.affiliation: Gastroenterology Department, Hospital Puerta de Hierro, Madrid, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Calleja
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000209:etiology*; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000150:complications*; D003365:Costs and Cost Analysis; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008320:Maltose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D009010:Monte Carlo Method; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D013395:Sucrose / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D005290:Ferric Compounds; D013395:Sucrose; C522335:ferric carboxymaltose; D008320:Maltose; D007501:Iron
keywords: Cost-minimization analysis; colorectal neoplasia; ferric carboxymaltose; iron deficiency; iron sucrose