Background Intravenous (IV) iron is frequently used in patients with iron deficiency (ID) when conventional oral ferrous products are ineffective or cannot be used (e.g. due to poor tolerability). Oral ferric maltol is a new iron ferric product registered in Europe and US. The aim of this study was to quantify the use of IV iron before and after the introduction of the new oral ferric maltol in real world settings and extrapolate the overall costs involved. Methods Data were collected from a single centre German clinical practice, MVZ für Immunologie, in inflammatory bowel disease (IBD) patients treated with iron therapy for ID with or without anaemia between 2013 and 2019 through the systematic CEDUR IBD registry and local medical records. The first cohort was formed of patients treated between 2013 and 2015, receiving only IV iron as ferric carboxymaltose (FCM). The second cohort was formed of patients treated between 2017 and 2019, receiving either oral ferric maltol only or ferric maltol in combination with FCM. Costs involved in each cohort were extrapolated using a societal perspective. Results Following the introduction of oral ferric maltol, the actual total number of FCM infusions observed was 138, showing a decrease of 70% compared to the first cohort in which oral ferric maltol was not available. This decreased number of infusions between the two cohorts was associated with total costs-savings of €56,933. In the first cohort, the administration costs were €44,536, the drug acquisition costs were €59,536 and the productivity loss were €30,944. In the second cohort, the administration costs were €13,597 the drug acquisition costs were €55,028 and the productivity loss were €9,447. A secondary scenario strictly applying the doses taken from respective SmPCs was tested and resulted in greater costs-savings. Noteworthy, the mean (SD) haemoglobin (Hb) level at baseline in the first cohort was lower with 11.5g/dl (1.19) vs. 12.2g/dl (1.18) in the second cohort. Three to six months after the treatment had been stopped, the mean (SD) Hb level was 13g/dl in both the first and second cohort with a SD of 1.31 and 1.37 respectively, showing that Hb levels were maintained in both cohorts. Conclusion The introduction of the new oral ferric maltol resulted in a decrease of 70% in terms of number of FCM infusions which was associated with costs-savings of €56,933 in terms of administration, drug acquisition and productivity loss costs. Considering that Hb levels were maintained in both cohorts, these results indicate that ID patients with or without anaemia previously treated with IV iron can also be managed effectively with oral ferric maltol resulting in overall societal cost-savings.
RESUMOConstante é a busca por materiais ecoeficientes aproveitando-se do potencial dos co-produtos e resíduos do biodiesel. Por meio de uma produção viável, este trabalho teve por objetivo a agregação das partes aéreas do girassol ao cimento Portland CP IV formando um compósito. Realizado em três etapas que foram: caracterização de resíduos, processamento de corpos de prova e ensaios. Fabricaram-se corpos de prova como matriz (CM) e corpos de prova com substituição de 10% de massa de agregado por resíduo de girassol (CG). Na pesquisa foram realizados ensaios de granulometria com o resíduo, de resistência à compressão (NBR 7215), de finura do cimento Portland (NBR 11579) e de tempo de pega (NM 65). Os resultados obtidos permitiram concluir que o compósito CG está dentro dos parâmetros exigidos na NBR 5736 de eficiência do CP IV, somente não alcançando a resistência à compressão desejada de 30 MPa. Palavras-chave:Cimento Portland. Girassol. Compósito. ABSTRACTSearching for ecofriendly materials by exploiting the potential of co-products and waste from biodiesel has been constant. The goal of the present work was to aggregate the sunflower aerial parts into the Portland CP IV cement forming a composite through a viable production. The three steps performed were: waste characterization, specimens processing and essays. Specimens were manufactured as matrix (CM) and specimens made of 10% of sunflower waste (CG). It was accomplished granulometry, from strenght to compression (NBR 7215) of the waste material, fineness of the Portland cement (NBR 11579) and cement setting time (NM 65). The results showed that the composite CG is in accordance with the parameters required by NBR 5736 of CP IV efficiency however the parameter resistence to the desired compression of 30 MPa was not reached.
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