Intravenous Iron Treatments For Iron Deficiency Anemia In Inflammatory Bowel Disease: A Budget Impact Analysis Of Iron Isomaltoside 1000 In The UK

Abstract

Iron deficiency (ID) is the leading cause of anemia in patients with inflammatory bowel disease (IBD). Intravenous iron should be considered the first-line iron-correction treatment in patients with clinically active IBD, hemoglobin <10g/dL, previous oral iron intolerance, or requiring erythropoiesis-stimulating agents. The study objective was to evaluate resource use and costs associated with using iron isomaltoside (Monofer; IIM) relative to other intravenous iron formulations in patients with iron deficiency anemia (IDA) associated with IBD. A budget impact model was developed to evaluate the cost of IIM relative to ferric carboxymaltose (Ferinject; FCM), low molecular weight iron dextran (Cosmofer; LMWID) and iron sucrose (Venofer; IS). Iron deficits were modeled using dosing tables and the need for retreatments was modeled using a pooled retrospective analysis of randomized trial data. The analysis was conducted over 5 years in patients with mean bodyweight of 75.4 kg (SD 17.4 kg) and hemoglobin levels of 10.8 g/dL (SD 1.4 g/dL) based on observational data from patients with IBD. Costs were modeled using healthcare resource groups. Using IIM required 1.29 infusions (per treatment) to correct the mean iron deficit, compared with 1.64, 1.29 and 7.14 with FCM, LMWID and IS, respectively. Patients using IIM required multiple infusions in 28.7% of cases, compared with, 64.3%, 28.7% and 100% with FCM, LMWID and IS, respectively. Total costs were estimated to be GBP 2,593 per patient with IIM or LMWID, relative to GBP 3,309 with FCM (savings of GBP 717 with IIM) or GBP 14,382 with IS (savings of GBP 11,789 with IIM). Using IIM in place of FCM or IS markedly reduced the number of infusions required to correct ID in patients with IBD and IDA. The reduction in infusions was accompanied by substantial reductions in cost relative to FCM and IS.