Cost-minimization analysis between intravenous iron sucrose and iron sucrose similar in hemodialysis patients

ABSTRACT

Objectives

Intravenous iron and erythropoiesis-stimulating agents are used to manage anemia in chronic hemodialysis patients. The interchangeability between intravenous iron sucrose preparations is still debated. We evaluated how cost and effectiveness were impacted when chronic hemodialysis patients were switched from an original iron sucrose product to an iron sucrose similar preparation.

Methods

A single center sequential observational retrospective study was conducted at a French hospital. The same patients were followed during two 24-week periods (iron sucrose in period P1; and iron sucrose similar in period P2). Anemia-related treatment costs were assessed in P1 and P2 from a hospital perspective. Sensitivity analyses were performed to assess the robustness of the results.

Results

Our study included 109 patients (105 analyzed patients and 4 patients with missing data). The mean hemoglobin level was not different between P1 and P2 (p = 0.92). The mean differential cost per patient was + €13.90 (P2 – P1). The factors with the biggest impact on this result were the prices of epoetin alfa and iron sucrose.

Conclusion

This cost minimization analysis suggests that for chronic hemodialysis patients, iron sucrose and iron sucrose similar have the same efficacy and that using iron sucrose similar was more expensive in 66.7% of iterations.

KEYWORDS:

• Iron sucrose
• iron sucrose similar
• cost-minimization analysis
• erythropoiesis-stimulating agent
• anemia
• chronic hemodialysis

Article Highlights

• Interchangeability between intravenous iron sucrose preparations is still debated since they are not considered as generics.

• We conducted a single center sequential observational retrospective study of 109 chronic hemodialysis patients treated with IV iron sucrose in period P1 (24 weeks) and an iron sucrose similar in period P2 (24 weeks).

• Mean hemoglobin levels and weekly doses of iron per patient remained stable between P1 and P2. We found a higher need for erythropoiesis-stimulating agents in P2 than in P1.

• The average differential cost per patient for the anemia treatment was +€13.90 (P2−P1).

• Sensitivity analyses revealed this result was influenced most by the epoetin alfa and iron sucrose prices.

Acknowledgments

We thank dialysis staff who participated in this study for their support and Joanne Archambault, PhD for English-language editing.

Author Contribution Statement

All authors were involved in the conception and design of the study and data interpretation. CP, SO, DS and MB were involved in collecting the data. AP, CP and BJC were involved in the statistic and economic analyses, and in preparing and revising the manuscript. IL, MP, BS and ADB provided essential advice on the focus of the analysis, methodology and clinical impacts. All authors jointly made the decision to submit the manuscript for publication.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Geolocation information

France

Additional information

Funding

This paper was not funded.