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评估在德国使用羧基麦芽糖铁进行围手术期缺铁性贫血管理的成本和效益。

Assessing the costs and benefits of perioperative iron deficiency anemia management with ferric carboxymaltose in Germany.

作者信息

Froessler Bernd, Rueger Alexandra M, Connolly Mark P

机构信息

Department of Anesthesia, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia.

Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA, Australia.

出版信息

Risk Manag Healthc Policy. 2018 Apr 24;11:77-82. doi: 10.2147/RMHP.S157379. eCollection 2018.

DOI:10.2147/RMHP.S157379
PMID:29731670
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5923254/
Abstract

BACKGROUND

Perioperative administration of ferric carboxymaltose (FCM) was previously shown to reduce both the need for transfusions and the hospital length of stay in patients with preoperative iron deficiency anemia (IDA). In this study, we estimated the economic consequences of perioperative administration using FCM vs usual care in patients with IDA from the perspective of a German hospital using decision-analytic modeling.

MATERIALS AND METHODS

The model was populated with clinical inputs (transfusion rates, blood units transfused, hospital length of stay) from a previously reported randomized trial comparing FCM vs usual care for managing IDA patients undergoing elective abdominal surgery. We applied a hospital perspective to all costs, excluding surgery-related costs in both treatment arms. One-way sensitivity analyses were undertaken to evaluate key drivers of cost analysis.

RESULTS

The average costs per case treated using FCM compared to usual care were €2,461 and €3,246, respectively, for resource expenses paid by hospital per case. This would suggest potential savings achieved with preoperative intravenous iron treatment per patient of €786 per case. A sensitivity analysis varying the key input parameters indicated the cost analysis is most sensitive to changes in the length of stay and the cost of hospitalization per day.

CONCLUSION

Perioperative administration of FCM results in cost savings to hospitals based on reduced blood transfusions and length of stay following elective abdominal surgery.

摘要

背景

先前的研究表明,围手术期给予羧基麦芽糖铁(FCM)可减少术前缺铁性贫血(IDA)患者的输血需求和住院时间。在本研究中,我们从一家德国医院的角度,使用决策分析模型评估了围手术期给予FCM与常规治疗相比的经济后果。

材料与方法

该模型采用了先前一项随机试验的临床数据(输血率、输血量、住院时间),该试验比较了FCM与常规治疗对接受择期腹部手术的IDA患者的疗效。我们将所有成本都从医院角度进行考量,两个治疗组均排除与手术相关的成本。进行了单因素敏感性分析以评估成本分析的关键驱动因素。

结果

医院为每个病例支付的资源费用中,使用FCM治疗的平均成本与常规治疗相比分别为2461欧元和3246欧元。这表明术前静脉注射铁剂治疗可为每位患者节省约786欧元/例的成本。对关键输入参数进行的敏感性分析表明,成本分析对住院时间和每日住院成本的变化最为敏感。

结论

围手术期给予FCM可减少择期腹部手术后患者的输血需求和住院时间,从而为医院节省成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/852f/5923254/29625684c197/rmhp-11-077Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/852f/5923254/29625684c197/rmhp-11-077Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/852f/5923254/29625684c197/rmhp-11-077Fig1.jpg

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