Cost-effectiveness analysis of parenteral iron therapy compared to oral iron supplements in managing iron deficiency anemia among pregnant women

Springer Science and Business Media LLC - Tập 14 - Trang 1-11 - 2024
Somen Saha1, Devang Raval1, Komal Shah1, Deepak Saxena1
1Indian Institute of Public Health, Gandhinagar, India

Tóm tắt

This study compared the clinical efficacy and cost-effectiveness of parenteral iron, using intravenous iron sucrose (IVIS) therapy against the standard regimen of oral iron (OI) therapy for managing iron-deficiency anemia (IDA) among pregnant women in a natural primary care setting in Gujarat. A prospective cost-effectiveness study was conducted in natural programme setting wherein 188 pregnant women in their 14 to 18 weeks with moderate and severe anemia women enrolled from two districts of Gujarat, and 142 were followed up until the post-partum phase. The intervention group comprised of 82 participants who were administered IVIS, while the comparison group comprised of 106 participants who were put on OI therapy. Hemoglobin (Hb) levels were measured at periodic intervals, first during enrollment and then during each month of pregnancy period and finally on the 42nd day of the post-natal period. Change in mean Hb level from baseline was the primary outcome, while the incidence of morbidity and mortality was a secondary outcome measure. The intervention group showed a significant incremental mean change in Hb level from 8.2 g/dl to 11.45 g/dl at the fourth follow-up, while the control group's mean Hb level reduced from 9.99 g/dl to 9.55 g/dl. The discounted cost per beneficiary for IVIS was US$ 87, while that for OI was US$ 49. The incremental cost-effectiveness ratio (ICER) was US$ 9.84, which is 0.049% of India's per capita GDP. IVIS therapy was more clinically effective and cost-effective than OI therapy among pregnant women for management of moderate and severe anemia.

Tài liệu tham khảo

Family N, Survey H. Government of India Ministry of Health and Family Welfare COMPENDIUM OF FACT SHEETS INDIA AND 14 STATES/UTs (Phase-11).

Jasani J, Trivedi J, Rajdev S, Pandya H. Hematological study of iron deficiency anemia in pregnancy in Central Gujarat. Int J Biomed Adv Res. 2019;10(3):7–9.

Marahatta R. Study of anaemia in pregnancy and its outcome in Nepal Medical College Teaching Hospital, Kathmandu. Nepal Nepal Med Coll J. 2007;9(4):270–4.

Neogi SB, Devasenapathy N, Singh R, Bhushan H, Shah D, Divakar H, Zodpey S, Malik S, Nanda S, Mittal P, Batra A, Chauhan MB, Yadav S, Dongre H, Saluja S, Malhotra V, Gupta A, Sangwan R, Radhika AG, Singh A, Bhaskaran S, Kotru M, Sikka M, Agarwal S, Francis P, Mwinga K, Baswal D. Safety and effectiveness of intravenous iron sucrose versus standard oral iron therapy in pregnant women with moderate-to-severe anaemia in India: a multicentre, open-label, phase 3, randomised, controlled trial. Lancet Glob Health. 2019 Dec;7(12):e1706-e1716. https://doi.org/10.1016/S2214-109X(19)30427-9. Erratum in: Lancet Glob Health. 2020;8(12):e1472.

EuroQoL EQ-5D-5L Index Value Calculator.

Department of Health Research - HTAIn [Internet]. [cited 2023 Dec 11]. https://dhr.gov.in/health-technology-assessment-india-htain. Available from: https://dhr.gov.in/sites/default/files/Policy%20Brief%20vol%202.pdf.