Economic appraisal of maintenance parenteral iron administration in treatment of anaemia in chronic haemodialysis patients

Abstract

Iron deficiency is very common in our haemodialysis population, especially in those patients receiving rHuEpo. A carefully monitored regimen of maintenance parenteral iron is a safe, effective, and economically favourable means of iron supplementation in patients with insufficient iron stores on maximum tolerated oral supplements.

Ferumoxytol for Treating Iron Deficiency Anemia in CKD

“…The possibility that some patients could be treated with intravenous iron alone or that appropriate intravenous iron replacement may delay initiation or reduce the dosage of ESA could improve care and reduce costs. 44,45 Safety concerns with ESA raised by recent clinical trials, 46 -48 which led to a Food and Drug Administration warning in their package insert, further make the case for appropriate intravenous iron therapy.…”

Impact of a Pharmacist-Implemented Anemia Management in Outpatients with End-Stage Renal Disease in Japan

“…Several attempts to maintain the hematocrit value by administering iron preparations and to decrease the consumption volume of erythropoietin preparations have been made from the pharmacoeconomic viewpoint in U.S.A. and Europe. [8][9][10] Most recently, even in Japan, a physicians' research group has reported that a small dose of iron preparations resulted in a 30% reduction of erythropoietin consumption for one year in Japan.…”

Parenteral Iron: Pharmacology and Clinical Use

“…In the United States and elsewhere, parenteral iron injections are advocated as the preferred route for anemia correction in chronic renal failure either alone or in combination with recombinant erythropoietin [12, 13, 14, 15, 16, 17]. When administered in combination with erythropoietin, parenteral iron injections purportedly enhance the response to erythropoietin, and consequently erythropoietin requirements may decline, resulting in substantial short-term cost savings [8, 13, 15].…”

“…When administered in combination with erythropoietin, parenteral iron injections purportedly enhance the response to erythropoietin, and consequently erythropoietin requirements may decline, resulting in substantial short-term cost savings [8, 13, 15]. …”

“…Whether this proposition holds in patients with chronic renal failure on hemodialysis – that response to parenteral iron may depend on the amount of dialysis they receive – is unclear. Unfortunately, the effect of dialysis dose on the response to intravenous iron-dextran infusions was not stated in any of the studies on parenteral iron use in patients with end-stage renal failure [8, 13, 14, 15, 16]. …”