A cost-comparative analysis of intravenous Ferric Carboxymaltose versus Iron Sucrose for the ambulatory treatment of Iron-deficiency Anemia in a major tertiary care hospital in Saudi Arabia

Abstract

<p class="MsoNormal" style="text-align: justify;"><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: EN-US;">Background:</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: EN-US;"> The objective of this study was to compare the cost of outpatient ferric carboxymaltose (FCM; Ferinject&reg;) versus Iron sucrose complex (ISC; Ferosac&reg;), two prevalent intravenous iron therapy used in the treatment of iron-deficiency anemia (IDA) in the Kingdom of Saudi Arabia (KSA) from a tertiary care hospital perspective.</span></p> <p class="MsoNormal" style="text-align: justify;"><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: EN-US;">Methods:</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: EN-US;"> A retrospective study was performed for all patients who were administered FCM in the outpatient clinical setting at Prince Sultan Military Medical City from January 1, 2019, until December 31, 2019. The descriptive data was analyzed using Microsoft Excel 2019 (Microsoft Corporation, Redmond, WA, USA). The total cost of treatment reflected the cost of drugs, the cost of disposables for each infusion, drug monitoring costs during infusion, the cost of productivity loss, and patient traveling cost.</span></p> <p class="MsoNormal" style="text-align: justify;"><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: EN-US;">Result:</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: EN-US;"> Overall, 993 patients with IDA, treated with FCM in 1,688 outpatient visits were recruited in the study. In the outpatient setting, the per annum cost of treatment was SAR 1,434,092.50 with FCM treatment and</span><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;"> </span><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: EN-US;">SAR 1,715,299.70 with ISC treatment, with a corresponding saving of 16.4% (SAR 281,207.20) with FCM. The cost savings with FCM treatment can be attributed to the reduced frequency of patient visits and corresponding reduction in drug monitoring costs (SAR </span><span lang="EN-GB" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;">266,995.20;</span><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: EN-US;">77.3%), loss of productivity per year (SAR </span><span lang="EN-GB" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;">163,550.20; </span><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: EN-US;">77.3%), and cost of transportation per year (SAR </span><span lang="EN-GB" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;">573,920.00; </span><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: EN-US;">77.3%).</span></p> <p class="MsoNormal" style="text-align: justify;"><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: EN-US;">Conclusion:</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: EN-US;"> The use of FCM, as opposed to ISC resulted in a reduced number of iron infusions (4.4 visits for ISC as compared to one visit for FCM), accompanied by a reduction in the total cost. FCM may represent a cost-saving option compared with the existing alternative therapy used for the management of IDA in KSA.</span></p>