Comparing costs of intramuscular and oral vitamin B₁₂ administration in primary care: A cost-minimization analysis

Abstract

Objective: To establish whether savings could be made by changing patients from intramuscular to high doses of oral vitamin B₁₂ in primary care without compromising their wellbeing. Methods: Cost-minimization analysis from a UK perspective, using secondary data obtained from the literature available and expert opinion. Results: The cost of the resources used to treat patients with vitamin B₁₂ deficiency with intramuscular vitamin B₁₂ was calculated as between £55.99 (€83.1) and £99.99 (€148.5) per year. The cost of treating patients with high doses of oral vitamin B₁₂ during the first year was between £125.55 (€186.5) and £248.55 (€369.1). However, once patients receiving intramuscular treatment had been converted to oral treatment, or in new patients treated orally from the outset, the cost was £35.55 per year (€52.8). One variable, home visits, had a high impact on the calculations.

Conclusion: Switching patients with vitamin B₁₂ deficiency from intramuscular to high-dose oral therapy and treating patients newly diagnosed with vitamin B₁₂ deficiency with oral vitamin B₁₂ from the outset could save resources in the medium and long term, and in newly diagnosed patients. Savings would come particularly in the form of nursing time.

• Cobalamin
• cost minimization
• pernicious anaemia
• vitamin B12