Assessment of Efficacy and Cost-Effectiveness of Oral and IV Iron Therapy in Chronic Kidney Disease
Abstract
Introduction: Long-term iron therapy for anemia in chronic kidney disease patients is creating an economic burden and discontinuation of the treatment. Objective: The purpose of this study was to assess the cost-effectiveness and efficacy of oral and intravenous iron therapy and iron therapy. Methods: the patients were distributed into group 1 and group 2 and were administered with oral and intravenous iron therapy respectively. Baseline hemoglobin and packed cell volume were recorded and subsequently monitored in the next follow-up visit to assess the efficacy of the iron therapy. Results: Among oral therapy, ferric citrate and ferric ascorbate were administered in 61 % and 39% of patients respectively. Among intravenous Iron sucrose and carboxymalotose were administered in 76% and 24% of patients respectively. There was a mean increase of 1.15g/dl and 2g/dl of hemoglobin with oral ferrous ascorbate and intravenous carboxymaltose therapy respectively. Conclusion: Thus, iron sucrose is found to be a cost-effective treatment. Ferrous ascorbate had more effect than ferric citrate and a lower cost compared to ferric citrate. This study revealed that oral ferrous ascorbate treatment is found to be cost-effective in chronic kidney disease with anemia.
Keywords: Iron therapy, cost-effective, anemia, hemoglobin, kidney disease.
Keywords:
Iron therapy, cost-effective, anemia, hemoglobin, kidney diseaseDOI
https://doi.org/10.22270/jddt.v13i11.6306References
George C, Mogueo A, Okpechi I, et al, Chronic kidney disease in low-income to middle-income countries: the case for increased screening. BMJ Global Health, 2017;2:e000256. https://doi.org/10.1136/bmjgh-2016-000256 PMid:29081996 PMCid:PMC5584488
Kazancioglu R. Risk factors for chronic kidney disease: an update. Kidney Int Suppl (2011). 2013;3(4):368-371. https://doi.org/10.1038/kisup.2013.79 PMid:25019021 PMCid:PMC4089662
Mallappallil M, Friedman EA, Delano BG, McFarlane SI, Salifu MO. Chronic kidney disease in the elderly: evaluation and management. Clin Pract (Lond). 2014;11(5):525-35. https://doi.org/10.2217/cpr.14.46 PMid:25589951 PMCid:PMC4291282
Anemia of Chronic Disease and Kidney Failure: Overview, Mechanism of Anemia of Chronic Disease, Prevalence of Anemia of Chronic Disease and CKD Available from: https://emedicine.medscape.com/article/1389854-overview
Frontiers | Anemia in Chronic Kidney Disease: From Pathophysiology and Current Treatments to Future Agents Available from: https://www.frontiersin.org/articles/10.3389/fmed.2021.642296/full
Das SN, Devi A, Mohanta BB, Choudhury A, Swain A, Thatoi PK. Oral versus intravenous iron therapy in iron deficiency anemia: An observational study. J Family Med Prim Care. 2020;9(7):3619-22. https://doi.org/10.4103/jfmpc.jfmpc_559_20 PMid:33102339 PMCid:PMC7567229
Aksan A, Beales ILP, Baxter G, de Arellano AR, Gavata S, Valentine WJ, et al. Evaluation of the Cost-Effectiveness of Iron Formulations for the Treatment of Iron Deficiency Anaemia in Patients with Inflammatory Bowel Disease in the UK. Clinicoecon Outcomes Res. 2021; 13:541-52. https://doi.org/10.2147/CEOR.S306823 PMid:34168471 PMCid:PMC8216635
Agrawal S, Sonawane S, Kumar S, Acharya S, Gaidhane SA, Wanjari A, et al. Efficacy of Oral Versus Injectable Iron in Patients with Chronic Kidney Disease: A Two-Year Cross-Sectional Study Conducted at a Rural Teaching Hospital. Cureus. 14(7):e27529.
Iron Infusion: Benefits, Side Effects & What to Expect Available from: https://my.clevelandclinic.org/health/treatments/14571-intravenous-iron-supplementation
Kriplani A, Pal B, Bhat V, Swami O. Ferrous Ascorbate: Current Clinical Place of Therapy in the Management of Iron Deficiency Anemia. Journal of South Asian Federation of Obstetrics and Gynaecology. 2021 Sep 9;13(3):103-9. https://doi.org/10.5005/jp-journals-10006-1896
Basha A, Ibrahim MIM, Hamad A, Chandra P, Omar NE, Abdullah MAJ, et al. Efficacy and cost effectiveness of intravenous ferric carboxymaltose versus iron sucrose in adult patients with iron deficiency anaemia. PLoS One. 2021 Aug 10;16(8): e0255104. https://doi.org/10.1371/journal.pone.0255104 PMid:34375369 PMCid:PMC8354439
Wong G, Howard K, Hodson E, Irving M, Craig JC. An economic evaluation of intravenous versus oral iron supplementation in people on haemodialysis. Nephrology Dialysis Transplantation. 2013;28(2):413-20. https://doi.org/10.1093/ndt/gfs487 PMid:23182811
Iron isomaltoside 1000: a new intravenous iron for treating iron deficiency in chronic kidney disease - PubMed [Internet]. Available from: https://pubmed.ncbi.nlm.nih.gov/21240875/
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