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01.12.2014 | Original Paper | Ausgabe 9/2014

The European Journal of Health Economics 9/2014

Budget impact of parenteral iron treatment of iron deficiency: methodological issues raised by using real-life data

Zeitschrift:
The European Journal of Health Economics > Ausgabe 9/2014
Autoren:
Elisabeth Brock, Peter Braunhofer, Josef Troxler, Heinz Schneider
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s10198-013-0533-9) contains supplementary material, which is available to authorized users.

Abstract

Objectives

Iron deficiency is common in pregnancy, postpartum, inflammatory bowel disease, chronic kidney disease, chronic heart failure, heavy uterine bleeding, cancer and following surgery. We estimate the budget impact (BI) on the Swiss mandatory health insurance associated with substituting iron sucrose (standard) with ferric carboxymaltose (new treatment) using real-life data.

Methods

Resource use was based on recent primary data (Polyquest Prescriber Analysis, Anemia Patient Record Study in Switzerland). Personnel costs were estimated using the Swiss Tarmed fee-for-service reimbursement system. Drug costs and costs of materials used were based on official tariffs (Spezialitätenliste, MiGeL). Actual IMS sales data of both products were used to verify the BI model (1 CHF ≈ 1 USD, Jan 2013).

Results

Ferric carboxymaltose was associated with cost savings of 30–44 % per patient per treatment cycle compared to iron sucrose. Costs per 200/500/1,000 mg total dosage treatment cycle were CHF 101/210/420 for ferric carboxymaltose and CHF 144/375/721 for iron sucrose. This results in cost savings of CHF 22–31 million across all indications in 2009. Savings were driven by personnel cost reductions (application time and number of applications). Sensitivity analyses confirmed these cost savings, even for the higher application costs of ferric carboxymaltose, with minimum savings of CHF 17 million per year.

Conclusions

Treating iron deficiency involves substantial costs to the Swiss MHI which may be reduced by substituting iron sucrose with ferric carboxymaltose. The use of real-life data raises methodological questions about the fundamental compatibility of this data with the conceptual framework of BI analysis.

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Zusatzmaterial
Supplementary material 1 (DOC 100 kb)
10198_2013_533_MOESM1_ESM.doc
Literatur
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