A Budget Impact Analysis of Iron Polymaltose and Ferric Carboxymaltose Infusions

Objective: To compare the direct costs of ferric carboxymaltose (FCM) infusions, and iron polymaltose (IPM) infused via either a slow or rapid infusion; and explore potential savings associated with increased uptake of the least-expensive option at a local hospital.Setting: Hospital staff responsible for manufacturing, administering, and monitoring iron infusions, and the patients that received them at the Royal Hobart Hospital in 2018. Method: Frequency analysis identified the most prescribed iron infusion doses. A time-motion methodology was used to calculate the direct costs for each protocol at these doses. Finally, a budget-impact analysis of encouraging increased use of the least-expensive infusion protocol was conducted. Main outcome measures: Total direct costs for each infusion protocol at common doses. Potential budget savings associated with switching to the lowest costing of these infusion protocols where possible.Results: The most common doses were 0.5g, 1g, 1.5g and 2g. At these dose points, FCM infusions are the least expensive, but only if national health subsidies are applied. In cases where they do not apply, IPM prepared from ampoules and infused using the rapid protocol (‘IPM Ampoules Rapid’) is the least expensive. Switching all applicable FCM infusions and IPM infusions administered using the slow infusion protocol to IPM Ampoules Rapid is projected to yield up to $12,000 worth of savings annually.Conclusions: Increased use of the IPM Ampoules Rapid protocol when government-subsidised options are not available is projected to have cost-saving outcomes. Investigation of implementation strategies to increase the use of this protocol are warranted.