Pharmacoeconomic analysis of using Monofer in patients with iron deficiency anemia as part of the provision of medical care under the state guarantees program in the health care system of the Russian Federation
https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.124
Abstract
Objective: comparative pharmacoeconomic analysis of iron preparations for intravenous infusion in the treatment of iron deficiency anemia (IDA) within the concept of patient blood management program.
Material and methods. A retrospective pharmacoeconomic study was carried out using methods of analysis of efficiency, costs and costeffectiveness. Comparison of preparations of oligoisomaltose iron [III] (Monofer) and carboxymaltose iron [III] (Ferinject®) was carried out.
Results. In general, Monofer and Ferinject® are characterized by comparable efficacy in terms of hematological response. Using a dosiological model of an increase in hemoglobin blood levels over time in treatment with the drugs under consideration the frequencies of the hematological response were calculated (Monofer – 79%, Ferinject® – 70%). The cost of treating one patient with an average body weight of 88.3 kg and an initial hemoglobin level of 100 g/l was 13,097 rubles for Monofer and 15,681 rubles for Ferinject®. The values of the cost-effectiveness indicator calculated in accordance with the criterion of the effectiveness of the hematological response amounted to 16,578 rubles (Monofer) and 22,402 rubles (Ferinject®), which allows to consider Monofer as strictly preferred. With the colorectal surgery as an example, it has been shown that the use of this drug in patients blood management can reduce the total cost of treatment (in particular, by reducing the required number of portions of red blood cells).
Conclusion. The wider use of iron preparations for intravenous infusion in IDA has reasonable economic advantages. The preparation of oligoisomaltose iron Monofer is strictly preferred in relation to the preparation of carboxymaltose iron.
About the Authors
R. I. YagudinaRussian Federation
Dr. Pharm. Sc., Professor, Chief of Chair of Drug Supply and Pharmacoeconomics,
8 bldg 2 Trubetskaya Str., Moscow 119991
A. Yu. Kulikov
Russian Federation
MD, PhD, Dr. Econ. Sc., Professor, Chair of Drug Supply and Pharmacoeconomics,
8 bldg 2 Trubetskaya Str., Moscow 119991
V. G. Serpik
Russian Federation
PhD (Pharm.), Associate Professor, Chief of Chair of Drug Supply and Pharmacoeconomics,
8 bldg 2 Trubetskaya Str., Moscow 119991
O. A. Gromova
Russian Federation
Dr. Med. Sc., Professor, Research Supervisor,
4 Vavilov Str., Moscow 211933
I. Yu. Torshin
Russian Federation
PhD (Phys. Math.), PhD (Chem.), Senior Researcher,
4 Vavilov Str., Moscow 211933
References
1. Peyrin-Biroulet L., Williet N., Cacoub P. Guidelines on the diagnosis and treatment of iron deficiency across indications: a systematic review. Am J Clin Nutr. 2015; 102 (6): 1585–94. https://doi.org/10.3945/ajcn.114.103366.
2. Hofmann A., Aapro M., Fedorova T.A., et al. Patient blood management in oncology in the Russian Federation: resolution to improve oncology care. Journal of Modern Oncology. 2020; 22 (3): 59–78 (in Russ.). https://doi.org/10.26442/18151434.2020.3.200340.
3. Clinical guidelines. Iron-deficiency anemia. 2021. Available at: https://labdep.com/storage/editor/JDA_2021_klin_rek.pdf (in Russ.) (accessed 05.02.2022).
4. Yagudina R.I., Kulikov A.Yu., Serpik V.G. Pharmacoeconomics. Tutorial. Rostov-on-Don: Feniks; 2018: 237 pp. (in Russ.).
5. Torshin I.Yu., Gromova O.A. Expert data analysis in molecular pharmacology. Moscow: MTsNMO; 2012: 748 pp. (in Russ.).
6. Markova I.V., Afanasyev V.V., Tsybulkin E.K. Clinical toxicology of children and adolescents. Saint Petersburg: Intermedika; 199: 399 pp. (in Russ.).
7. Jahn M.R., Andreasen H.B., Fütterer S., et al. A comparative study of the physicochemical properties of iron isomaltoside 1000 (Monofer), a new intravenous iron preparation and its clinical implications. Eur J Pharm Biopharm. 2011; 78 (3): 480–91. https://doi.org/10.1016/j.ejpb.2011.03.016.
8. State Register of Medicines. Available at: https://grls.rosminzdrav.ru (in Russ.) (accessed 02.09.2021).
9. Gordon M., Sinopoulou V., Iheozor-Ejiofor Z., et al. Interventions for treating iron deficiency anaemia in inflammatory bowel disease. Cochrane Database Syst Rev. 2021; 1 (1): CD013529. https://doi.org/10.1002/14651858.CD013529.pub2.
10. Shin H.W., Go D.Y., Lee S.W., et al. Comparative efficacy and safety of intravenous ferric carboxymaltose and iron sucrose for iron deficiency anemia in obstetric and gynecologic patients: a systematic review and meta-analysis. Medicine (Baltimore). 2021; 100 (20): e24571. https://doi.org/10.1097/MD.0000000000024571.
11. Aksan A., Işık H., Radeke H.H., et al. Systematic review with network meta-analysis: comparative efficacy and tolerability of different intravenous iron formulations for the treatment of iron deficiency anaemia in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2017; 45 (10): 1303–18. https://doi.org/10.1111/apt.14043.
12. Pollock R.F., Muduma G. A systematic literature review and indirect comparison of iron isomaltoside and ferric carboxymaltose in iron deficiency anemia after failure or intolerance of oral iron treatment. Expert Rev Hematol. 2019; 12 (2): 129–36. https://doi.org/10.1080/17 474086.2019.1575202.
13. The official website of the Unified Information System in the Field of Procurement. Available at: https://zakupki.gov.ru (in Russ.) (accessed 03.09.2021).
14. The state register of manufacturers' maximum selling prices for medicines included in the list of vital and essential medicines. Available at: https://minzdrav.gov.ru/opendata/7707778246-gosreestrpredelnyhotpusknyhcen/visual (in Russ.) (accessed 02.09.2021).
15. Schaefer B., Tobiasch M., Viveiros A., et al. Hypophosphataemia after treatment of iron deficiency with intravenous ferric carboxymaltose or iron isomaltoside-a systematic review and meta-analysis. Br J Clin Pharmacol. 2021; 87 (5): 2256–73. https://doi.org/10.1111/bcp.14643.
16. Pollock R.F., Muduma G. A patient-level cost-effectiveness analysis of iron isomaltoside versus ferric carboxymaltose for the treatment of iron deficiency anemia in the United Kingdom. J Med Econ. 2020; 23 (7): 751–9. https://doi.org/10.1080/13696998.2020.1745535.
17. City Polyclinic No. 2 of the Moscow City Health Department. Cost of services. Available at: https://gp2dzm.ru/stoimost-uslug (in Russ.) (accessed 04.09.2021).
18. Trentino K.M., Mace H., Symons K., et al. Associations of a preoperative anemia and suboptimal iron stores screening and management clinic in colorectal surgery with hospital cost, reimbursement, and length of stay: a net cost analysis. Anish Analog. 2021; 132 (2): 344–52. https://doi.org/10.1213/ANE.0000000000005241.
19. Bagova M.O., Magomedova A.U., Kravchenko S.K., et al. Pharmacoeconomic analysis of R-DA-EPOCH and R-mNHL-BFM-90 combination immunochemotherapy in patients with prognostically unfavorable diffuse large B-cell lymphoma within randomized multi-center clinical trial DLBCL-2015. Clinical Oncohematology. 2021; 14 (3): 321–32 (in Russ.). https://doi.org/10.21320/2500-2139-2021-14-3-321-332.
20. Serov V.N. (Ed.) Diagnostics and treatment of perioperative anemia and iron deficiency in surgical patients: methodological guide. Cheboksary: ID Sreda; 2021: 60 pp. (in Russ.).
21. Price list of the Invitro laboratory network. Available at: https://www.invitro.ru (in Russ.) (accessed 04.09.2021).
22. Kulnigg S., Stoinov S., Simanenkov V., et al. A novel intravenous iron formulation for treatment of anemia in inflammatory bowel disease: the ferric carboxymaltose (FERINJECT) randomized controlled trial. Am J Gastroenterol. 2008; 103 (5): 1182–92. https://doi.org/10.1111/j.1572-0241.2007.01744.x.
23. Lima J., Gago P., Rocha M., et al. Role of intravenous iron in the treatment of anemia in patients with gastrointestinal tract tumors undergoing chemotherapy: a single-center, observational study. Int J Gen Med. 2018; 11: 331–6. https://doi.org/10.2147/IJGM.S165947.
24. Slaats J., ten Oever J., van der Veerdonk F.L., Netea M.G. IL-1β/ IL-6/СRP and IL-18/ferritin: distinct inflammatory programs in infections. PloS Pathog. 2016; 12 (12): e1005973. https://doi.org/10.1371/journal.ppat.1005973.
25. Torshin I.Yu., Gromova O.A. Micronutrients against coronaviruses. Moscow: GEOTAR-Media; 2020: 112 pp. (in Russ.).
26. Bach M., Geisel T., Martin J., et al. Efficacy and safety of intravenous ferric carboxymaltose in geriatric inpatients at a German Tertiary University Teaching Hospital: a retrospective observational cohort study of clinical practice. Anemia. 2015; 2015: 647930. https://doi.org/10.1155/2015/647930.
27. Keeler B.D., Simpson J.A., Ng S., et al. The feasibility and clinical efficacy of intravenous iron administration for preoperative anaemia in patients with colorectal cancer. Colorectal Dis. 2014; 16 (10): 794– 800. https://doi.org/10.1111/codi.12683.
28. Moore R.A., Gaskell H., Rose P., Allan J. Meta-analysis of efficacy and safety of intravenous ferric carboxymaltose (Ferinject) from clinical trial reports and published trial data. BMC Blood Disord. 2011; 11: 4. https://doi.org/10.1186/1471-2326-11-4.
29. Ifie E., Oyibo S.O., Joshi H., Akintade O. Symptomatic hypophosphataemia after intravenous iron therapy: an underrated adverse reaction. Endocrinol Diabetes Metab Case Rep. 2019; 2019 (1): 19–0065. https://doi.org/10.1530/EDM-19-0065.
30. Jensen G., Gøransson L.G., Fernström A., et al. Treatment of iron deficiency in patients with chronic kidney disease: a prospective observational study of iron isomaltoside (NIMO Scandinavia). Clin Nephrol. 2019; 91 (4): 246–53. https://doi.org/10.5414/CN109474.
31. Wikström B., Bhandari S., Barany P., et al. Iron isomaltoside 1000: a new intravenous iron for treating iron deficiency in chronic kidney disease. J Nephrol. 2011; 24 (5): 589–96. https://doi.org/10.5301/JN.2011.6248.
32. Kalra P.A., Bhandari S., Saxena S., et al. A randomized trial of iron isomaltoside 1000 versus oral iron in non-dialysis-dependent chronic kidney disease patients with anaemia. Nephrol Dial Transplant. 2016; 31 (4): 646–55. https://doi.org/10.1093/ndt/gfv293.
33. Clemmensen S.Z., Kragholm K.H., Melgaard D., et al. Association between intravenous iron therapy and short-term mortality risk in older patients undergoing hip fracture surgery: an observational study. J Orthop Surg Res. 2021; 16 (1): 320. https://doi.org/10.1186/s13018-021-02462-x.
34. Goh H.J., Lee K.S., Kim T.H., et al. Intravenous iron isomaltoside 1000 reduces postoperative anemia in patients undergoing elective urologic surgery and those with urosepsis. Drug Des Devel Ther. 2020; 14: 5679–87. https://doi.org/10.2147/DDDT.S276904.
35. Johansson P.I., Rasmussen A.S., Thomsen L.L. Intravenous iron isomaltoside 1000 (Monofer) reduces postoperative anaemia in preoperatively non-anaemic patients undergoing elective or subacute coronary artery bypass graft, valve replacement or a combination thereof: a randomized double-blind placebo-controlled clinical trial (the PROTECT trial). Vox Sang. 2015; 109 (3): 257–66. https://doi.org/10.1111/vox.12278.
36. Holm C., Thomsen L.L., Langhoff-Roos J. Intravenous iron isomaltoside treatment of women suffering from severe fatigue after postpartum hemorrhage. J Matern Fetal Neonatal Med. 2019; 32 (17): 2797–804. https://doi.org/10.1080/14767058.2018.1449205.
37. Gybel-Brask M., Seeberg J., Thomsen L.L., Johansson P.I. Intravenous iron isomaltoside improves hemoglobin concentration and iron stores in female iron-deficient blood donors: a randomized double-blind placebo-controlled clinical trial. Transfusion. 2018; 58 (4): 974–81. https://doi.org/10.1111/trf.14521.
38. Dahlerup J.F., Jacobsen B.A., van der Woude J., et al. High-dose fast infusion of parenteral iron isomaltoside is efficacious in inflammatory bowel disease patients with iron-deficiency anaemia without profound changes in phosphate or fibroblast growth factor 23. Scand J Gastroenterol. 2016; 51 (11): 1332–8. https://doi.org/10.1080/00365521.2016.1196496.
39. Federal Antimonopoly Service. Maximum sizes of wholesale surcharges and maximum sizes of retail surcharges to prices for vital and essential medicines established in the subjects of the Russian Federation (data as of 21.10.2020). Available at: https://fas.gov.ru/documents/687272 (in Russ.) (accessed 01.07.2021).
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For citations:
Yagudina R.I., Kulikov A.Yu., Serpik V.G., Gromova O.A., Torshin I.Yu. Pharmacoeconomic analysis of using Monofer in patients with iron deficiency anemia as part of the provision of medical care under the state guarantees program in the health care system of the Russian Federation. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2022;15(1):73-86. (In Russ.) https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.124

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