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

Abstract

Background: Ferric Carboxymaltose (FCM), Iron Sucrose (IS) and Oral Iron (OI) are alternative treatments for preoper-ative anaemia. Objective: To compare the cost implications, using a cost-minimization analysis, of three alternatives: FCM vs. IS vs. OIfor treating iron-deficient anaemia before surgery in patients with colon cancer. Methods: Data from 282 patients with colorectal cancer and anaemia were obtained from a previous study. One hundred andeleven received FCS, 16 IS and 155 OI. Costs of intravenous iron drugs were obtained from the Spanish Regulatory Agency. Direct and indirect costs were obtained from the analytical accounting unit of the Hospital. In the base case mean costs perpatient were calculated. Sensitivity analysis and probabilistic Monte Carlo simulation were performed. Results: Total costs per patient were 1827R© in the FCM group, 2312R© in the IS group and 2101R©i n the OI group. Costsavings per patient for FCM treatment were 485R© compared to IS and 274R© compared to OI. A Monte Carlo simulationfavoured the use of FCM in 84.7% and 84.4% of simulations when compared to IS and OI, respectively. Conclusions: FCM infusion before surgery reduced costs in patients with colon cancer and iron-deficiency anaemia whencompared with OI and IS.