Evaluating the Costs of Perioperative Iron-Deficiency Anemia Management in China: A Comparison of Ferric Derisomaltose, Ferric Carboxymaltose, and Usual Care
Author(s)
Yu Xia, MD1, Wei Li, MD2, Yuan Feng, MSc3, Richard F. Pollock, MA, MSci4.
1Peking University People's Hospital, Beijing, China, 2International Research Center for Medicinal Administration, Peking University, Beijing, China, 3Real World Solutions, IQVIA China, Shanghai, China, 4Covalence Research Ltd, Harpenden, United Kingdom.
1Peking University People's Hospital, Beijing, China, 2International Research Center for Medicinal Administration, Peking University, Beijing, China, 3Real World Solutions, IQVIA China, Shanghai, China, 4Covalence Research Ltd, Harpenden, United Kingdom.
OBJECTIVES: To estimate the budget impact of adopting ferric derisomaltose (FDI) or ferric carboxymaltose (FCM) for peri-operative patient blood management (PBM) in patients with iron-deficiency anaemia (IDA) undergoing major abdominal surgery, compared with usual care (no pre-operative intravenous iron) from the Chinese public hospital perspective.
METHODS: A budget impact model was developed to model PBM in major abdominal surgery. Iron infusion, blood transfusion, ward stay, and hypophosphataemia management costs were obtained from published Chinese tariffs and literature (2024 CNY). Patient characteristics (baseline bodyweight and haemoglobin levels) were obtained from a Chinese randomized controlled trial (RCT) of FCM. PBM and other clinical parameters (transfusion rates, length of stay [LoS], and hypophosphataemia incidence) were obtained from other RCTs on the use of intravenous iron in PBM.
RESULTS: FDI resulted in the lowest budget impact with a total cost of CNY 5,445, of which 22% was associated with PBM and 78% with the post-surgical LoS. Overall costs of using FCM were CNY 199 higher (CNY 5,644), driven by CNY 115 for phosphate monitoring and a further CNY 145 in hypophosphataemia-related ward stay, although these were partially offset by a lower acquisition cost of FCM versus FDI. Usual care was the most expensive option, with total costs of CNY 6,761 driven primarily by the longer ward stay with usual care; only 3% of costs in the usual care scenario were driven by PBM-related costs.
CONCLUSIONS: The use of pre-operative FDI in Chinese patients with IDA undergoing major abdominal surgery resulted in the lowest costs from the hospital perspective, with cost savings versus FCM driven by the lack of phosphate monitoring costs, and reduced hypophosphataemia-related ward stay. Both intravenous iron formulations substantially reduced expenditure versus usual care driven by shorter LoS. These findings would support prioritising the use of FDI in PBM pathways in China.
METHODS: A budget impact model was developed to model PBM in major abdominal surgery. Iron infusion, blood transfusion, ward stay, and hypophosphataemia management costs were obtained from published Chinese tariffs and literature (2024 CNY). Patient characteristics (baseline bodyweight and haemoglobin levels) were obtained from a Chinese randomized controlled trial (RCT) of FCM. PBM and other clinical parameters (transfusion rates, length of stay [LoS], and hypophosphataemia incidence) were obtained from other RCTs on the use of intravenous iron in PBM.
RESULTS: FDI resulted in the lowest budget impact with a total cost of CNY 5,445, of which 22% was associated with PBM and 78% with the post-surgical LoS. Overall costs of using FCM were CNY 199 higher (CNY 5,644), driven by CNY 115 for phosphate monitoring and a further CNY 145 in hypophosphataemia-related ward stay, although these were partially offset by a lower acquisition cost of FCM versus FDI. Usual care was the most expensive option, with total costs of CNY 6,761 driven primarily by the longer ward stay with usual care; only 3% of costs in the usual care scenario were driven by PBM-related costs.
CONCLUSIONS: The use of pre-operative FDI in Chinese patients with IDA undergoing major abdominal surgery resulted in the lowest costs from the hospital perspective, with cost savings versus FCM driven by the lack of phosphate monitoring costs, and reduced hypophosphataemia-related ward stay. Both intravenous iron formulations substantially reduced expenditure versus usual care driven by shorter LoS. These findings would support prioritising the use of FDI in PBM pathways in China.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE439
Topic
Economic Evaluation, Methodological & Statistical Research, Study Approaches
Topic Subcategory
Budget Impact Analysis
Disease
Surgery, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)