Original article

Blood Transfusion 5-2018 (September-October)

Cost-effectiveness analysis of ferric carboxymaltose in pre-operative haemoglobin optimisation in patients undergoing primary knee arthroplasty

Authors

Key words: anaemia, iron-deficiency, cost-effectiveness, knee replacement, erythrocyte transfusion
Publication Date: 2018-06-26

Abstract

Background. An analytic-decision model was built to estimate the cost-effectiveness of using ferric carboxymaltose for pre-operative haemoglobin optimisation in patients with iron deficiency anaemia undergoing primary knee arthroplasty.
Materials and methods. We simulated 20,000 patients who were randomly assigned to the haemoglobin optimisation arm or the non-optimisation control arm in a strict 1:1 ratio. The main outcomes were cost per patient transfusion avoided and red blood cell units spared. The analyses were performed from the hospital perspective with length of stay as the time horizon.
Results. In the reference case scenario, pre-operative haemoglobin optimisation led to fewer patients being exposed to allogeneic red blood cell transfusion (2,212 vs 6,595 out of 10,000 patients) and a relevant decrease in the number of red blood cell units transfused (4.342 vs 13.336). The costs of avoiding one patient transfusion and sparing one red blood cell unit were € 831 and € 405, respectively. Increased costs in the optimisation arm were mostly associated with the outpatient day hospital visit (54%) and ferric carboxymaltose treatment (40%).
Discussion. In primary knee arthroplasty, pre-operative haemoglobin optimisation with intravenous ferric carboxymaltose is less expensive than other reported patient blood management modalities and must be considered in patients with iron deficiency anaemia.

Downloads

Authors

Misericordia Basora - Department of Anaesthesiology, Hospital Clinic Barcelona, Barcelona, Spain

Arturo Pereira - Department of Haemotherapy and Haemostasis, Hospital Clinic Barcelona, Barcelona, Spain

Miquel Coca - Department of Anaesthesiology, Hospital Clinic Barcelona, Barcelona, Spain

Montse Tió - Department of Anaesthesiology, Hospital Clinic Barcelona, Barcelona, Spain

Lluís Lozano - Department of Orthopaedic Surgery, Hospital Clinic Barcelona, Barcelona, Spain

  • Abstract viewed - 120 times
  • PDF downloaded - 48 times