BACKGROUND: Intravenous iron therapy is advantageous in case of intolerance to oral iron or blood loss. Several intravenous iron substitutes are available (ferric carboxymaltose [F-Rx], iron sucrose [F-Sx] and iron isomaltoside) with varying prices, infusion rates and safety profiles. F-Rx was approved in Prince Sultan Military Medical City (PSMMC) for only the ambulatory treatment of iron-deficiency anemia while, F-Sx has no such restrictions.

OBJECTIVES: This study aimed to compare the cost of outpatient intravenous F-Rx versus intravenous F-Sx for iron-deficiency anemia in a major tertiary hospital in the Kingdom of Saudi Arabia.

METHODS: This retrospective analysis included all patients with iron-deficiency anemia, treated with F-Rx in outpatient setting at PSMMC from January 1, 2019 to December 31, 2019. The healthcare costs of F-Rx and F-Sx were compared. The cost parameters included medication, nursing staff, equipment, patient transportation and loss of productivity.

RESULTS: A total of 993 patients with iron-deficiency anemia received F-Rx in outpatient setting in 1,688 visits, of which 90.2% (n=1,522) were female patient visits. To administer a complete iron dose, a patient required 4.4 visits for F-Sx compared to a single visit for F-Rx. The total cost per visit per male/female patient treated with F-Rx and F-Sx were SAR 1017.5/SAR 831.3 and SAR 398.9/SAR212.6, respectively. In comparison to F-Sx, F-Rx was associated with total cost saving of 42.0% and 11.1% per male and female patient per course of treatment, respectively. The overall annual cost for F-Rx was SAR 1,434,092.5, a 16.4% (SAR 281,207.2) reduction of that of F-Sx (SAR 1,715,299.7).

CONCLUSIONS: The cost-comparative analysis results indicate F-Rx has higher cost-saving benefits than F-Sx for hospitals, healthcare providers and patients along with reduced frequency of hospital visits. In the present COVID-19 scenario, fewer hospital visits benefit both the patient to reduce COVID-19 exposure and the hospital to free up capacity.