Pharmacoeconomics of ferric carboxymaltose in patients with iron deficiency anemia: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

SUN Wentao , TIAN Lei ,  MA Aixia

School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing 211198, P. R. China;

Corresponding?author：

MA Aixia, Email: aixiama73@126.com

Keywords：

Ferric carboxymaltose; Iron deficiency anemia; Pharmacoeconomics; Systematic review

DOI：

10.7507/1672-2531.202201022

Video：

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Objective To systematically review the pharmacoeconomics of high-dose intravenous iron ferric carboxymaltose in the treatment of patients with iron deficiency anemia. Methods Pharmacoeconomic studies of ferric carboxymaltose in the treatment of patients with iron deficiency anemia were searched in PubMed, The Cochrane Library, York University CRD, Web of Science, EBSCO, CNKI, WanFang Data and VIP databases, and relevant health technology assessment websites from inception to September 30^th, 2021. A descriptive analysis was performed after two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Results A total of 11 studies were included, most of them compared the health economics of ferric carboxymaltose with other therapies from a hospital perspective. The main costs included in these studies were costs for iron, infusion, blood transfusion, EPO, hospitalization, and transportation, as well as productivity cost. The ferric carboxymaltose was presumed to be more economical than other intravenous irons. Conclusion It is suggested that the ferric carboxymaltose be considered in more clinical settings to improve the ischemic condition of patients with iron deficiency anemia, so as to promote the rational utilization of medical resources.

Citation： SUN Wentao, TIAN Lei, MA Aixia. Pharmacoeconomics of ferric carboxymaltose in patients with iron deficiency anemia: a systematic review. Chinese Journal of Evidence-Based Medicine, 2022, 22(8): 926-931. doi: 10.7507/1672-2531.202201022 Copy

1.	World Health Organization. Iron deficiency anaemia assessment, prevention and control: a guide for programme managers. Geneva: World Health Organization. Available at: http://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdf.
2.	國家衛生健康委員會. 中國居民營養與慢性病狀況報告(2020年). 營養學報, 2020, 42(6): 521.
3.	中國營養學會"缺鐵性貧血營養防治專家共識"工作組. 缺鐵性貧血營養防治專家共識. 營養學報, 2019, 41(5): 417-426.
4.	周宗科, 翁習生, 向兵, 等. 中國髖, 膝關節置換術加速康復—圍術期貧血診治專家共識. 中華骨與關節外科雜志, 2016, 9(1): 10-15.
5.	Raji YR, Ajayi SO, Akingbola TS, et al. Assessment of iron deficiency anaemia and its risk factors among adults with chronic kidney disease in a tertiary hospital in Nigeria. Niger Postgrad Med J, 2018, 25(4): 197-203.
6.	Filmann N, Rey J, Schneeweiss S, et al. Prevalence of anemia in inflammatory bowel diseases in european countries: a systematic review and individual patient data meta-analysis. Inflamm Bowel Dis, 2014, 20(5): 936-945.
7.	Locatelli F, Pisoni RL, Combe C, et al. Anaemia in haemodialysis patients of five European countries: association with morbidity and mortality in the dialysis outcomes and practice patterns study (DOPPS). Nephrol Dial Transplant, 2004, 19(1): 121-132.
8.	McLean E, Cogswell M, Egli I, et al. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993-2005. Public Health Nutr, 2009, 12(4): 444-454.
9.	凌寒. 我國缺鐵性貧血已造成顯著疾病負擔復旦大學發布中國缺鐵性貧血疾病負擔和診療現狀研究成果. 中國當代醫藥, 2012, 19(32): 1.
10.	Banerjee S, McCormack S. Intravenous iron preparations for patients undergoing elective surgery: a review of clinical effectiveness, cost-effectiveness, and guidelines. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health, 2019.
11.	陳敏. 羧基麥芽糖鐵的臨床研究進展. 藥學與臨床研究, 2021, 29(2): 117-121.
12.	Chiou CF, Hay JW, Wallace JF, et al. Development and validation of a grading system for the quality of cost-effectiveness studies. Med Care, 2003, 41(1): 32-44.
13.	Aksan A, Beales ILP, Baxter G, et al. Evaluation of the cost-effectiveness of iron formulations for the treatment of iron deficiency anaemia in patients with inflammatory bowel disease in the UK. Clinicoecon Outcomes Res, 2021, 13: 541-552.
14.	Basha A, Ibrahim MIM, Hamad A, et al. Efficacy and cost effectiveness of intravenous ferric carboxymaltose versus iron sucrose in adult patients with iron deficiency anaemia. PLoS One, 2021, 16(8): e0255104.
15.	Aksan A, Schoepfer A, Juillerat P, et al. Iron Formulations for the treatment of iron deficiency anemia in patients with inflammatory bowel disease: a cost-effectiveness analysis in Switzerland. Adv Ther, 2021, 38(1): 660-677.
16.	Pollock RF, Muduma G. A patient-level cost-effectiveness analysis of iron isomaltoside versus ferric carboxymaltose for the treatment of iron deficiency anemia in the United Kingdom. J Med Econ, 2020, 23(7): 751-759.
17.	Rognoni C, Ortalda V, Biasi C, et al. Economic evaluation of ferric carboxymaltose for the management of hemodialysis patients with iron deficiency anemia in Italy. Adv Ther, 2019, 36(11): 3253-3264.
18.	Marinho J, Le?o I, Custódio S, et al. Ferric carboxymaltose in the treatment of chemotherapy-induced anaemia: an effective, safe and cost- sparing alternative to blood transfusion. Sci Rep, 2019, 9(1): 20410.
19.	Fragoulakis V, Kourlaba G, Goumenos D, et al. Economic evaluation of intravenous iron treatments in the management of anemia patients in Greece. Clinicoecon Outcomes Res, 2012, 4: 127-134.
20.	Calvet X, Gené E, àngelRuíz M, et al. 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. Technol Health Care, 2016, 24(1): 111-120.
21.	Lim EA, Sohn HS, Lee H, et al. Cost-utility of ferric carboxymaltose (Ferinject?) for iron-deficiency anemia patients with chronic heart failure in South Korea. Cost Eff Resour Alloc, 2014, 12: 19.
22.	Luporsi E, Mahi L, Morre C, et al. Evaluation of cost savings with ferric carboxymaltose in anemia treatment through its impact on erythropoiesis-stimulating agents and blood transfusion: French healthcare payer perspective. J Med Econ, 2012, 15(2): 225-232.
23.	Bager P, Dahlerup JF. The health care cost of intravenous iron treatment in IBD patients depends on the economic evaluation perspective. J Crohns Colitis, 2010, 4(4): 427-430.
24.	Jung R, Yoo JJ, Tan R, et al. PSU8 health economic evaluation of protocol change including IV iron ferric carboxymaltose versus control group for HIP surgery patients with iron deficiency anemia (IDA) in Korea. Value Health, 2020, 22: S105.
25.	Luporsi E, Mahi L, Moore C, et al. PCN28 Cost savings with ferric carboxymaltose through its impact on erythropo?esis-stimulating agents and blood transfusion in chemotherapy-induced anemia of breast and gastrointestinal cancer: french health care payer perspective. Value Health, 2011, 14: A159-A160.
26.	Ryazhenov VV, Gorokhova SG, Maximkin SA, et al. Pharmacoeconomic analysis of ferric carboxymaltose in patients with colon cancer and anemia. Value Health, 2015, 18: A444.
27.	Walter E, Lazic-Peric A, Schalle K, et al. Cost-effectiveness of ferric carboxymaltose (FCM) in the treatment of iron deficiency anemia in patients with inflammatory bowel disease (IBD). Value Health, 2017, 20: A634-A635.
28.	Gutzwiller FS, Blank PR, Gasche C, et al. PMO-257 cost-effectiveness and cost comparison of intravenous iron preparations in patients with IBD-associated iron deficiency anaemia based on the FERGImain trial. Gut, 2012, 61: A180.
29.	Ferreira D, Silva M, Vandewalle B, et al. PSY6 economic efficiency of ferric carboxymaltose to treat or prevent iron deficiency anemia: value to the portuguese hospitals. Value Health, 2012, 15: A509.
30.	Gorokhova SG, Ryazhenov VV, Emchenko IV. Pharmacoeconomic evaluation of intravenous ferric carboxymaltose and iron sucrose in correction of preoperative anaemia in patients undergoing major elective surgery. Value Health, 2013, 16: A379-A380.
31.	Zakin L, Asbun-Bojalil J, Chiu-Ugalde J, et al. Health economic evaluation of ferric carboxymaltose (ferinject?) in patients with iron deficiency anemia. Value Health, 2014, 17: A229.
32.	Fragoulakis V, Kourlaba G, Goumenos D, et al. Economic evaluation of ferinject in the treatment of anemia patients in the greek hospital setting: a cost minimization analysis. Value Health, 2011, 14: A416.
33.	Ong DEH, Hadi F, Stevens V. Health economic evaluation comparing iv iron ferric carboxymaltose, iron sucrose and blood transfusion for treatment of patients with iron deficiency anemia (Ida) in Singapore. Value Health, 2014, 17(7): A784.
34.	Lacquaniti A, Pasqualetti P, Tocco TCD, et al. Ferric carboxymaltose versus ferric gluconate in hemodialysis patients: Reduction of erythropoietin dose in 4 years of follow-up. Kidney Res Clin Pract, 2020, 39(3): 334-343.
35.	Hofman JMG, Eisenga MF, Diepenbroek A, et al. Switching iron sucrose to ferric carboxymaltose associates to better control of iron status in hemodialysis patients. BMC Nephrol, 2018, 19(1): 242.
36.	Bisbe E, García-Erce JA, Díez-Lobo AI, et al. A multicentre comparative study on the efficacy of intravenous ferric carboxymaltose and iron sucrose for correcting preoperative anaemia in patients undergoing major elective surgery. Br J Anaesth, 2011, 107(3): 477-478.
37.	Calleja JL, Delgado S, del Val A, et al. Ferric carboxymaltose reduces transfusions and hospital stay in patients with colon cancer and anemia. Int J Colorectal Dis, 2016, 31(3): 543-551.
38.	Froessler B, Palm P, Weber I, et al. The important role for intravenous iron in perioperative patient blood management in major abdominal surgery: a randomized controlled trial. Ann Surg, 2016, 264(1): 41-46.
39.	Khalafallah AA, Yan C, Al-Badri R, et al. Intravenous ferric carboxymaltose versus standard care in the management of postoperative anaemia: a prospective, open-label, randomised controlled trial. Lancet Haematol, 2016, 3(9): e415-425.
40.	Spahn DR, Schoenrath F, Spahn GH, et al. Effect of ultra-short-term treatment of patients with iron deficiency or anaemia undergoing cardiac surgery: a prospective randomised trial. Lancet, 2019, 393(10187): 2201-2212.
41.	Kim SK, Seo WY, Kim HJ, et al. Postoperative intravenous ferric carboxymaltose reduces transfusion amounts after orthopedic hip surgery. Clin Orthop Surg, 2018, 10(1): 20-25.
42.	Lyman GH, Berndt ER, Kallich JD, et al. The economic burden of anemia in cancer patients receiving chemotherapy. Value Health, 2005, 8(2): 149-156.
43.	Ershler WB, Chen K, Reyes EB, et al. Economic burden of patients with anemia in selected diseases. Value Health, 2005, 8(6): 629-638.

1. World Health Organization. Iron deficiency anaemia assessment, prevention and control: a guide for programme managers. Geneva: World Health Organization. Available at: http://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdf.
2. 國家衛生健康委員會. 中國居民營養與慢性病狀況報告(2020年). 營養學報, 2020, 42(6): 521.
3. 中國營養學會"缺鐵性貧血營養防治專家共識"工作組. 缺鐵性貧血營養防治專家共識. 營養學報, 2019, 41(5): 417-426.
4. 周宗科, 翁習生, 向兵, 等. 中國髖, 膝關節置換術加速康復—圍術期貧血診治專家共識. 中華骨與關節外科雜志, 2016, 9(1): 10-15.
5. Raji YR, Ajayi SO, Akingbola TS, et al. Assessment of iron deficiency anaemia and its risk factors among adults with chronic kidney disease in a tertiary hospital in Nigeria. Niger Postgrad Med J, 2018, 25(4): 197-203.
6. Filmann N, Rey J, Schneeweiss S, et al. Prevalence of anemia in inflammatory bowel diseases in european countries: a systematic review and individual patient data meta-analysis. Inflamm Bowel Dis, 2014, 20(5): 936-945.
7. Locatelli F, Pisoni RL, Combe C, et al. Anaemia in haemodialysis patients of five European countries: association with morbidity and mortality in the dialysis outcomes and practice patterns study (DOPPS). Nephrol Dial Transplant, 2004, 19(1): 121-132.
8. McLean E, Cogswell M, Egli I, et al. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993-2005. Public Health Nutr, 2009, 12(4): 444-454.
9. 凌寒. 我國缺鐵性貧血已造成顯著疾病負擔復旦大學發布中國缺鐵性貧血疾病負擔和診療現狀研究成果. 中國當代醫藥, 2012, 19(32): 1.
10. Banerjee S, McCormack S. Intravenous iron preparations for patients undergoing elective surgery: a review of clinical effectiveness, cost-effectiveness, and guidelines. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health, 2019.
11. 陳敏. 羧基麥芽糖鐵的臨床研究進展. 藥學與臨床研究, 2021, 29(2): 117-121.
12. Chiou CF, Hay JW, Wallace JF, et al. Development and validation of a grading system for the quality of cost-effectiveness studies. Med Care, 2003, 41(1): 32-44.
13. Aksan A, Beales ILP, Baxter G, et al. Evaluation of the cost-effectiveness of iron formulations for the treatment of iron deficiency anaemia in patients with inflammatory bowel disease in the UK. Clinicoecon Outcomes Res, 2021, 13: 541-552.
14. Basha A, Ibrahim MIM, Hamad A, et al. Efficacy and cost effectiveness of intravenous ferric carboxymaltose versus iron sucrose in adult patients with iron deficiency anaemia. PLoS One, 2021, 16(8): e0255104.
15. Aksan A, Schoepfer A, Juillerat P, et al. Iron Formulations for the treatment of iron deficiency anemia in patients with inflammatory bowel disease: a cost-effectiveness analysis in Switzerland. Adv Ther, 2021, 38(1): 660-677.
16. Pollock RF, Muduma G. A patient-level cost-effectiveness analysis of iron isomaltoside versus ferric carboxymaltose for the treatment of iron deficiency anemia in the United Kingdom. J Med Econ, 2020, 23(7): 751-759.
17. Rognoni C, Ortalda V, Biasi C, et al. Economic evaluation of ferric carboxymaltose for the management of hemodialysis patients with iron deficiency anemia in Italy. Adv Ther, 2019, 36(11): 3253-3264.
18. Marinho J, Le?o I, Custódio S, et al. Ferric carboxymaltose in the treatment of chemotherapy-induced anaemia: an effective, safe and cost- sparing alternative to blood transfusion. Sci Rep, 2019, 9(1): 20410.
19. Fragoulakis V, Kourlaba G, Goumenos D, et al. Economic evaluation of intravenous iron treatments in the management of anemia patients in Greece. Clinicoecon Outcomes Res, 2012, 4: 127-134.
20. Calvet X, Gené E, àngelRuíz M, et al. 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. Technol Health Care, 2016, 24(1): 111-120.
21. Lim EA, Sohn HS, Lee H, et al. Cost-utility of ferric carboxymaltose (Ferinject?) for iron-deficiency anemia patients with chronic heart failure in South Korea. Cost Eff Resour Alloc, 2014, 12: 19.
22. Luporsi E, Mahi L, Morre C, et al. Evaluation of cost savings with ferric carboxymaltose in anemia treatment through its impact on erythropoiesis-stimulating agents and blood transfusion: French healthcare payer perspective. J Med Econ, 2012, 15(2): 225-232.
23. Bager P, Dahlerup JF. The health care cost of intravenous iron treatment in IBD patients depends on the economic evaluation perspective. J Crohns Colitis, 2010, 4(4): 427-430.
24. Jung R, Yoo JJ, Tan R, et al. PSU8 health economic evaluation of protocol change including IV iron ferric carboxymaltose versus control group for HIP surgery patients with iron deficiency anemia (IDA) in Korea. Value Health, 2020, 22: S105.
25. Luporsi E, Mahi L, Moore C, et al. PCN28 Cost savings with ferric carboxymaltose through its impact on erythropo?esis-stimulating agents and blood transfusion in chemotherapy-induced anemia of breast and gastrointestinal cancer: french health care payer perspective. Value Health, 2011, 14: A159-A160.
26. Ryazhenov VV, Gorokhova SG, Maximkin SA, et al. Pharmacoeconomic analysis of ferric carboxymaltose in patients with colon cancer and anemia. Value Health, 2015, 18: A444.
27. Walter E, Lazic-Peric A, Schalle K, et al. Cost-effectiveness of ferric carboxymaltose (FCM) in the treatment of iron deficiency anemia in patients with inflammatory bowel disease (IBD). Value Health, 2017, 20: A634-A635.
28. Gutzwiller FS, Blank PR, Gasche C, et al. PMO-257 cost-effectiveness and cost comparison of intravenous iron preparations in patients with IBD-associated iron deficiency anaemia based on the FERGImain trial. Gut, 2012, 61: A180.
29. Ferreira D, Silva M, Vandewalle B, et al. PSY6 economic efficiency of ferric carboxymaltose to treat or prevent iron deficiency anemia: value to the portuguese hospitals. Value Health, 2012, 15: A509.
30. Gorokhova SG, Ryazhenov VV, Emchenko IV. Pharmacoeconomic evaluation of intravenous ferric carboxymaltose and iron sucrose in correction of preoperative anaemia in patients undergoing major elective surgery. Value Health, 2013, 16: A379-A380.
31. Zakin L, Asbun-Bojalil J, Chiu-Ugalde J, et al. Health economic evaluation of ferric carboxymaltose (ferinject?) in patients with iron deficiency anemia. Value Health, 2014, 17: A229.
32. Fragoulakis V, Kourlaba G, Goumenos D, et al. Economic evaluation of ferinject in the treatment of anemia patients in the greek hospital setting: a cost minimization analysis. Value Health, 2011, 14: A416.
33. Ong DEH, Hadi F, Stevens V. Health economic evaluation comparing iv iron ferric carboxymaltose, iron sucrose and blood transfusion for treatment of patients with iron deficiency anemia (Ida) in Singapore. Value Health, 2014, 17(7): A784.
34. Lacquaniti A, Pasqualetti P, Tocco TCD, et al. Ferric carboxymaltose versus ferric gluconate in hemodialysis patients: Reduction of erythropoietin dose in 4 years of follow-up. Kidney Res Clin Pract, 2020, 39(3): 334-343.
35. Hofman JMG, Eisenga MF, Diepenbroek A, et al. Switching iron sucrose to ferric carboxymaltose associates to better control of iron status in hemodialysis patients. BMC Nephrol, 2018, 19(1): 242.
36. Bisbe E, García-Erce JA, Díez-Lobo AI, et al. A multicentre comparative study on the efficacy of intravenous ferric carboxymaltose and iron sucrose for correcting preoperative anaemia in patients undergoing major elective surgery. Br J Anaesth, 2011, 107(3): 477-478.
37. Calleja JL, Delgado S, del Val A, et al. Ferric carboxymaltose reduces transfusions and hospital stay in patients with colon cancer and anemia. Int J Colorectal Dis, 2016, 31(3): 543-551.
38. Froessler B, Palm P, Weber I, et al. The important role for intravenous iron in perioperative patient blood management in major abdominal surgery: a randomized controlled trial. Ann Surg, 2016, 264(1): 41-46.
39. Khalafallah AA, Yan C, Al-Badri R, et al. Intravenous ferric carboxymaltose versus standard care in the management of postoperative anaemia: a prospective, open-label, randomised controlled trial. Lancet Haematol, 2016, 3(9): e415-425.
40. Spahn DR, Schoenrath F, Spahn GH, et al. Effect of ultra-short-term treatment of patients with iron deficiency or anaemia undergoing cardiac surgery: a prospective randomised trial. Lancet, 2019, 393(10187): 2201-2212.
41. Kim SK, Seo WY, Kim HJ, et al. Postoperative intravenous ferric carboxymaltose reduces transfusion amounts after orthopedic hip surgery. Clin Orthop Surg, 2018, 10(1): 20-25.
42. Lyman GH, Berndt ER, Kallich JD, et al. The economic burden of anemia in cancer patients receiving chemotherapy. Value Health, 2005, 8(2): 149-156.
43. Ershler WB, Chen K, Reyes EB, et al. Economic burden of patients with anemia in selected diseases. Value Health, 2005, 8(6): 629-638.

Chinese Journal of Evidence-Based Medicine

Pharmacoeconomics of ferric carboxymaltose in patients with iron deficiency anemia: a systematic review

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