OBJECTIVES

Intravenous (IV) iron is the preferred treatment for patients with iron deficiency anemia (IDA) who cannot tolerate or absorb oral iron, or who require fast resolution of anemia pre-operatively. Several IV iron formulations are available with different dosing characteristics affecting infusion speed and maximum dose. The aim was to develop a tool to calculate the cost of establishing an IV iron service and model resource impact of different IV irons to inform clinicians and service providers implementing innovative pre-operative IV iron services in Ireland.

METHODS

A resource impact tool was developed to model resource utilization and IDA treatment costs. Two fast-administration, high-dose formulations of IV iron are available in Ireland: iron isomaltoside (IIM) and ferric carboxymaltose (FCM). The tool modeled clinic throughput based on their different dosing characteristics in a specific IDA population, capturing fixed overheads, variable costs, clinic income from private and publically-funded patients, and savings associated with IV iron.

RESULTS

Based on a 70:30 split between public and private patients in a new pre-operative service with capacity for 600 infusions annually, IIM would facilitate correction of iron deficits in 446 patients, resulting in a net annual clinic balance of €−6,872 on income of €153,977 and costs of €160,849. FCM would facilitate treatment of 339 patients, resulting in a net annual clinic balance of €−10,023 on income of €115,056 and costs of €125,079. List price discounts of 3.49% and 7.28% would be required to breakeven with IIM and FCM, respectively; the differential increasingly favors IIM as further discounts are applied.

CONCLUSIONS

Based on this provider-perspective analysis, IIM would result in capacity and revenue optimization that could drive a service provision business case, allowing clinicians in Ireland to evaluate their current service provision and expenditure and model the impact of introducing IV iron clinics for pre-operative patients with IDA.