Momoeda Mikio, Ito Kyoko, Inoue Sachie, Shibahara Hidetoshi, Mitobe Yuko, Komatsu Norio
Aiiku Maternal and Child Health Center, Aiiku Hospital, 1-16-10 Shibaura, Minato-Ku, Tokyo, 105-8321, Japan.
Medical Affairs Department, Torii Pharmaceutical Co., Ltd., 3-4-1 Nihonbashi-Honcho, Chuo-Ku, Tokyo, 103-8439, Japan.
Int J Hematol. 2025 Apr;121(4):467-475. doi: 10.1007/s12185-024-03905-x. Epub 2024 Dec 26.
We investigated the cost-effectiveness of treating iron deficiency anemia (IDA) with ferric citrate hydrate (FC) in Japan. We employed four treatment strategies: switching from sodium ferrous citrate (SF) to FC at (1) 500 mg (approximately 120 mg of iron) per day or (2) 1000 mg (approximately 240 mg of iron) per day in patients with SF-induced nausea/vomiting, or starting treatment with FC at (3) 500 mg/day or (4) 1000 mg/day. We evaluated the cost-effectiveness of these strategies compared with SF 100 mg (100 mg of iron) per day. Incremental effects over 26 weeks relative to SF 100 mg were 0.0052 quality-adjusted life years (QALYs) for (1) and (2), and 0.0044 QALYs for (3) and (4). From the payer's perspective, incremental cost-effectiveness ratios (ICERs: JPY/QALY) against SF 100 mg were: (1) 1,107,780, (2) 2,257,477, (3) 5,588,430, and (4) 11,544,816. All four FC strategies were dominant (less costly and more effective) from a limited societal perspective. Treatment with FC for IDA was cost-effective (ICER ≤ JPY 5,000,000/QALY) when switching strategies from the payer perspective, and cost-saving (all FC strategies) from limited societal perspectives. Individual patients' characteristics and cost-effectiveness should be considered in treatment selection.
我们在日本研究了用柠檬酸铁水合物（FC）治疗缺铁性贫血（IDA）的成本效益。我们采用了四种治疗策略：对于因服用枸橼酸亚铁（SF）出现恶心/呕吐的患者，分别以每天（1）500毫克（约120毫克铁）或（2）1000毫克（约240毫克铁）的剂量从SF换用FC，或者分别以每天（3）500毫克或（4）1000毫克的剂量开始使用FC进行治疗。我们评估了这些策略与每天服用100毫克（100毫克铁）SF相比的成本效益。相对于每天服用100毫克SF，在26周内的增量效果方面，（1）和（2）为0.0052质量调整生命年（QALY），（3）和（4）为0.0044 QALY。从支付方的角度来看，与每天服用100毫克SF相比，增量成本效益比（ICER：日元/QALY）分别为：（1）1,107,780，（2）2,257,477，（3）5,588,430，（4）11,544,816。从有限的社会视角来看，所有四种FC策略都具有优势（成本更低且效果更好）。从支付方角度转换策略时，用FC治疗IDA具有成本效益（ICER≤5,000,000日元/QALY），从有限的社会视角来看则节省成本（所有FC策略）。在选择治疗方案时应考虑个体患者的特征和成本效益。
