Presentation (CTI)

OBJECTIVES: Anemia is a global health problem, and the most common cause is iron deficiency anemia, affecting approximately one-sixth of the global population. This study compares healthcare resource utilization (HCRU) and costs among intravenous iron (IV iron) users with and without concomitant hemotherapy.
METHODS: Retrospective longitudinal study using administrative claims data from a health plan from January/2019-December/2024. Beneficiaries with at least one record of IV iron use were identified and stratified into two groups: concomitant hemotherapy plus IV iron (Hemotherapy+IV Iron) and IV iron only. Demographic characteristics, comorbidity burden, HCRU, hospitalization rates, average length of stay (LOS), and annual healthcare costs were assessed.
RESULTS: Among 60,825 eligible beneficiaries, 895 received IV iron, prevalence of 3,058 users per 100,000 beneficiaries. IV iron users were older (mean age 69 years) and predominantly female (66%). Overall, healthcare utilization was substantial, with annual averages of 6.5 visits, 2.9 emergency visits, 99.8 tests, 23.7 therapy sessions, and 1.61 hospitalizations per beneficiary. Mean LOS was 11.5 days. Of IV iron users, 502 (56.1%) received concomitant hemotherapy and 393 (43.9%) received IV iron only. Hemotherapy+IV Iron group incurred 2.6-fold higher annual healthcare costs than the IV Iron Only group (BRL 184,746 vs. BRL 70,913). They also experienced higher hospitalization rates (1.72 vs. 1.43 admissions per beneficiary-year) and longer LOS (14.57 vs. 6.72 days), suggesting greater clinical complexity and healthcare needs. Despite the high economic burden, direct IV iron costs represented only 0.11% of total healthcare expenditures, while hemotherapy accounted for 0.98%.
CONCLUSIONS: Among IV iron users, concomitant hemotherapy was associated with substantially higher healthcare costs, hospitalization rates, and LOS. Although IV iron and hemotherapy contributed minimally to total expenditures of total expenditures, their use identified a clinically complex and resource-intensive patient subgroup. Earlier identification and management of iron deficiency may represent an opportunity to improve care pathways and optimize HCRU.