Cost-effectiveness analysis of ferric carboxymaltose (FCM) versus sucrosomial iron (SI) for the treatment of iron deficiency anemia (IDA) after cardiac surgery

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background A recent study compared a short-term treatment to correct IDA using FMC or SI showing a significant improvement for both treatments on key hematological parameters and in functional capacity(1). Obviously the choice of oral supplementation, is safe and avoid intravenous administration. In addition, a pharmaco-economic analysis was conducted to evaluate the direct and indirect costs of the two treatments used in the referring study. Methods The cost analysis was performed on all 106 patients (P) included in the study, taking into account both direct and indirect costs. Direct costs include the cost for the products (FCM and SI) purchase, provided by the internal hospital pharmacy, the cost of the second dietary supplement (CardioSideral®), and direct costs of NaCl injection solution and disposable materials estimate by the internal hospital pharmacy. In this setting the patients who received intravenous iron was already hospitalized, so it is impossible to quantify the healthcare professional 's time and the cost of hospitalization (indirect costs). Transportation and lost productivity costs for P are also not applicable. Results Costs provided by internal hospital pharmacy of direct purchasing of the products are 42.6 € per vial of FSM and 42 € per unit of SI. Each patient of FCM group received 2 vials , corresponding to 85.20 €/patient; each patient of SI group received 40 doses, considering that 1 unit contains 160 doses, the costs per patient is 10.50 €. SI supplement costs 26.50 € per patient, but it is not in charge of the National Health Service (NHS). Costs of NaCl injection solution and other disposable materials are 0.987 €/patient (to be considered only for the FCM group). Table 1 summarizes the above costs and shows the potential saving per patient and for the hospital, considering only costs in charge of the NHS. Conclusions The pharmaco-economic analysis showed a potential saving of € 49.18 per patient, considering only the direct costs of purchasing the products, and an average annual saving of € 4086.72 € every approximately 55 patients admitted to inpatient cardiac rehabilitation after cardiac surgery, with IDA. For outpatient patients, should also be considered the indirect costs sustained by the hospital, which would further increase the gap between these two types of iron treatment. In conclusion, SI is undoubtedly more cost-effective than FCM, treating IDA after cardiac surgery.