Optimizing Adherence to Intravenous Iron: A Geographic Analysis of Variability Within the United States
Author(s)
Craig J. Beavers, PharmD1, Linda Armstrong, MSN, FNP-BC, AOCNP2, Sophia Humphreys, PharmD, MHA3, Michael Polson, MS, PharmD4;
1University of Kentucky College of Pharmacy/Baptist Health System, Lexington, KY, USA, 2Icahn School of Medicine at Mount Sinai, New York, NY, USA, 3Providence Health System, Seattle, WA, USA, 4Pharmacosmos Therapeutics Inc., Morristown, NJ, USA
1University of Kentucky College of Pharmacy/Baptist Health System, Lexington, KY, USA, 2Icahn School of Medicine at Mount Sinai, New York, NY, USA, 3Providence Health System, Seattle, WA, USA, 4Pharmacosmos Therapeutics Inc., Morristown, NJ, USA
OBJECTIVES: Explore differences in adherence to intravenous iron (IVI) products across various healthcare plan types in the US.
METHODS: A retrospective analysis of commercial and Medicare administrative claims data from Komodo's Healthcare Map was performed. Adult patients with iron deficiency anemia (IDA) before their first IVI infusion (index date) and treated on or after January 1, 2020 were included; patients with reduced kidney function were excluded. Adherence was defined as receiving >1,000 mg of IVI within 6-weeks of the index period. Infusion locations were categorized into four U.S. Census Bureau regions (West, Midwest, Northeast, South) based on provider zip codes.
RESULTS: The analysis included 303,133 patients (commercial = 197,878; Medicare = 105,255). Most commercial patients were female (84.74%) with a mean age of 45.65 years, while 65.14% of Medicare patients were female with a mean age of 72.22 years. National adherence rates were similar across healthcare plans (commercial: 65.23%; Medicare: 65.94%). Regional adherence rates for commercial patients: West (60.70%), Midwest (61.42%), Northeast (64.85%), South (68.16%); for Medicare patients: West (62.63%), Midwest (63.58%), Northeast (64.06%), South (66.66%). Adherence was highest in Tennessee (commercial: 78.32%), Alaska (Medicare: 85.71%) and lowest in Hawaii (commercial: 40.67%), New Hampshire (Medicare: 51.34%). Across plans, ferric derisomaltose had the highest adherence (commercial 99.57%, Medicare 98.90%) while sodium ferric gluconate had the lowest (commercial 11.42%, Medicare 11.06%). Single-dose ferric derisomaltose had higher adherence than two-dose ferumoxytol and ferric carboxymaltose.
CONCLUSIONS: This analysis highlights the variability in IVI adherence across healthcare plans and regions, with south and west regions showing the highest and lowest adherence, respectively. Ferric derisomaltose showed the highest adherence, suggesting potential to simplify regimens and optimize therapy. These findings emphasize the need to better understand how regional care systems and product-specific factors, individually or combined, can optimize outcomes in IDA through adherence.
METHODS: A retrospective analysis of commercial and Medicare administrative claims data from Komodo's Healthcare Map was performed. Adult patients with iron deficiency anemia (IDA) before their first IVI infusion (index date) and treated on or after January 1, 2020 were included; patients with reduced kidney function were excluded. Adherence was defined as receiving >1,000 mg of IVI within 6-weeks of the index period. Infusion locations were categorized into four U.S. Census Bureau regions (West, Midwest, Northeast, South) based on provider zip codes.
RESULTS: The analysis included 303,133 patients (commercial = 197,878; Medicare = 105,255). Most commercial patients were female (84.74%) with a mean age of 45.65 years, while 65.14% of Medicare patients were female with a mean age of 72.22 years. National adherence rates were similar across healthcare plans (commercial: 65.23%; Medicare: 65.94%). Regional adherence rates for commercial patients: West (60.70%), Midwest (61.42%), Northeast (64.85%), South (68.16%); for Medicare patients: West (62.63%), Midwest (63.58%), Northeast (64.06%), South (66.66%). Adherence was highest in Tennessee (commercial: 78.32%), Alaska (Medicare: 85.71%) and lowest in Hawaii (commercial: 40.67%), New Hampshire (Medicare: 51.34%). Across plans, ferric derisomaltose had the highest adherence (commercial 99.57%, Medicare 98.90%) while sodium ferric gluconate had the lowest (commercial 11.42%, Medicare 11.06%). Single-dose ferric derisomaltose had higher adherence than two-dose ferumoxytol and ferric carboxymaltose.
CONCLUSIONS: This analysis highlights the variability in IVI adherence across healthcare plans and regions, with south and west regions showing the highest and lowest adherence, respectively. Ferric derisomaltose showed the highest adherence, suggesting potential to simplify regimens and optimize therapy. These findings emphasize the need to better understand how regional care systems and product-specific factors, individually or combined, can optimize outcomes in IDA through adherence.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD160
Topic
Real World Data & Information Systems
Disease
SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain), STA: Nutrition