PUK13 - THE TREATMENT OF IRON DEFICIENCY/ANAEMIA IN PATIENTS WITH NON-DIALYSIS CHRONIC KIDNEY DISEASE IN GERMANY – A CLAIMS DATABASE ANALYSIS

Abstract

Iron deficiency/anaemia (ID/A) has been reported as a frequent comorbidity in non-dialysis chronic kidney disease (ND CKD) and is associated with reduced functional capacity, poor quality of life, and increased mortality. Study aims were to compare health-related outcomes and healthcare costs of ND CKD patients with ID/A and specific iron treatment in Germany. A retrospective, matched cohort analysis was conducted. German claims data from the InGef research database containing over 4 million covered lives were used. ND CKD patients stages 3 and 4 with ID/A were identified by ICD-10-GM codes in 2014 with individual pre- and post-index periods of 4 quarters. Incident iron treatment defined the index quarter and was stratified by oral, low dose (<1000mg) and high dose (≥1000mg) intravenous iron based on Anatomical Therapeutic Chemical Classification codes and Pharmacy Central Numbers. A 1:1:1 propensity score matching was performed including the parameters age, gender, Charlson Comorbidity Index, and baseline costs to assess health-related outcomes. In total, n=1,889 ND CKD patients received oral iron, n=156 low dose intravenous, and n=49 high dose intravenous iron with over 90% being treated with Ferric Carboxymaltose. After matching, 44 patients remained in each treatment cohort. Significant differences were observed concerning all-cause hospitalizations (oral iron vs. high dose intravenous iron (90.9% vs. 72.7%, p=0.035)) and ID/A-related hospitalizations (oral iron vs. low dose intravenous iron (56.8% vs. 27.3%, p=0.007) and oral iron vs. high dose intravenous iron (56.8% vs. 29.6%, p=0.007)). The cost comparison revealed significantly higher average ID/A-related hospitalization costs for the oral iron cohort and lowest costs for the high intravenous iron cohort. The oral iron cohort had the highest observable mortality. The results showed that the use of high dose intravenous iron treatment was associated with the lowest all-cause hospitalization and the highest cost savings, compared to oral and low dose intravenous iron.