Increased Length and Cost of Hospital Stay in Inpatients with Iron Deficiency Anemia Experiencing Moderate-Severe Hypophosphatemia after Administration of Ferric Carboxymaltose
Author(s)
Fragkos KC1, Pollock R2, Sehgal V1, Rahman F1
1University College London Hospitals NHS Foundation Trust, London, UK, 2Covalence Research Ltd., London, LON, UK
Presentation Documents
Intravenous (IV) iron is the mainstay of treatment for iron deficiency anemia (IDA), when oral iron cannot be used or there is a need for rapid iron delivery. Ferric carboxymaltose (FCM) is a widely used IV iron preparation known to cause moderate/severe hypophosphatemia (serum phosphate <0.65mmol/L; <2mg/dL) in up to 75% of patients. This study aimed to analyze length of hospital stay (LoS) and related cost in inpatients with no/mild versus moderate/severe hypophosphatemia post-FCM treatment.
METHODS A patient-level model was developed to evaluate LoS and related cost in inpatients with IDA of various etiologies treated with FCM at University College Hospital, London, UK (N=162 inpatients; 169 iron treatment courses). LoS and costs were modeled in patients with no/mild hypophosphatemia (n=112 treatment courses) and moderate/severe (n=57 treatment courses) hypophosphatemia. Analyses were conducted across 107 non-elective healthcare resource group (HRG) tariffs with finite trimpoints weighted using NHS England Hospital Episode Statistics (HES). Costs were calculated based on excess stay costs for stays longer than the HRG trimpoint. RESULTS Mean LoS was 10.9 days (standard deviation [SD] 13.4 days) in patients with no/mild hypophosphatemia versus 18.0 days (SD 19.8 days; p=0.0035) in patients with moderate/severe hypophosphatemia. The cost analysis weighted by the 107 non-elective HRG tariffs showed an excess stay cost of GBP 1,159 in patients with no/mild hypophosphatemia versus GBP 2,435 in patients with moderate/severe hypophosphatemia, a difference of GBP 1,275 (+110%) per hospital spell. CONCLUSIONS Patients with moderate/severe hypophosphatemia after FCM treatment experienced significantly longer hospital stay than patients with no/mild hypophosphatemia. A patient-level HRG-based cost analysis weighted by HES data showed that the excess stay cost was 110% higher in the group with moderate/severe hypophosphatemia versus no/mild hypophosphatemia. The excess cost associated with hypophosphataemia may therefore represent an additional substantial cost of treatment with FCM that should be considered in future economic evaluations.Conference/Value in Health Info
Value in Health, Volume 24, Issue 5, S1 (May 2021)
Code
PSY7
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Cardiovascular Disorders, Drugs, Gastrointestinal Disorders, Systemic Disorders/Conditions