OBJECTIVES:

Evaluate the number of intravenous iron (IVI) repletion episodes in US commercially insured patients with iron deficiency anemia (IDA).

METHODS:

This was a retrospective study using administrative claims data between January 2016 and December 2019 for adults enrolled in a commercial insurance program with a regional health plan. Episodes of IVI therapy, defined as the six weeks following the initial infusion, were measured for each IVI

product received. All patients included were required to have a claim for an IVI product, the first of which was the index date. A diagnosis of IDA was required in the baseline (12-months prior to index) period and patients were followed for one year beginning on the index date. Patients were excluded if they weren’t enrolled for the 24-month (baseline + follow-up) study period or underwent hemodialysis at any time. Groups were determined according to generation of IVI product received: older generation (iron dextran, ferric gluconate, iron sucrose) and newer generation (ferumoxytol, ferric carboxymaltose). Ferric derisomaltose was excluded as it was not approved during the study period.

RESULTS:

There were 24,736 patients included in this study. Baseline demographics were similar between the two cohorts. Those who used older generation versus newer generation IVI products had an average of 1.73 vs 1.32 treatment episodes, respectively. Four times as many patients on older generation products required ≥4 treatment episodes compared to newer generation products (8% vs 2%, respectively).

CONCLUSIONS:

This study supported previous findings that showed patients who received older, lower dose IV iron products are less likely to resolve their IDA. Furthermore, discordance could lead to patients having to repeat courses of therapy. Restrictive health plan policies that require steps through the older generation products may lead to increased logistical burden on both patients and infusion centers.