Rapid infusion protocol of iron polymaltose saves cost in management of iron deficiency anaemia

Abstract

Increased use of iron polymaltose (IPM) given via a new rapid infusion protocol for the treatment of iron-deficiency anaemia (IDA) could generate substantial budget savings for a tertiary hospital in Australia. This is the one of the findings of a study that compared the direct costs of iron infusions commonly used for the management of IDA in Australia: IPM prepared from ampoules, infused slowly over 2–3 hours; IPM prepared from premix bags, infused slowly over 2–3 hours; or ferric carboxymaltose (FCM) 1g weekly given in a single 15-min infusion. A budget-impact analysis was conducted to explore potential savings associated with increased uptake of the lowest-cost protocol at a tertiary hospital. The cost analysis, which used data from a total of 1274 iron infusions prescribed at Royal Hobart Hospital in 2018, showed that FCM infusions were associated with the lowest cost at all dose points when Pharmaceutical Benefits Scheme (PBS) subsidies applied, with total direct costs ranging from $A16.99 per infusion for the 500mg dose point to $A45.12 for the 1500mg dose point. However, for non-subsidised infusions, this was the most costly protocol, with total direct costs ranging from $A182.06 to $A649.73 per infusion. For non-subsidised infusions, IPM given via a new rapid infusion protocol (IPM Ampoules Rapid) had the lowest total direct cost irrespective of the dose prescribed, with costs ranging from $A75.91 to $A156.14 per infusion. The potential savings associated with switching any FCM infusions that do not meet subsidy requirements and IPM slow infusion protocols to IPM Ampoules Rapid were estimated at nearly $A12 000 annually. Our findings support the increasing uptake of IPM rapid protocols in Australia, suggest the researchers.