BACKGROUND Oral iron is recommended as first line treatment of anemia in non-dialysis chronic kidney disease (ND-CKD) patients. Sucrosomial® iron, a new generation oral iron with high absorption and bioavailability and a low incidence of side effects, has shown to be not inferior to intravenous (IV) iron in the replacement of iron deficiency anemia in patients with ND-CKD. Besides the clinical benefit, it is also important to determine the comparative total costs of oral versus IV iron administrations. The aim of this study was to perform a cost-minimization analysis of oral Sucrosomial iron, compared with IV iron gluconate from an Italian societal perspective. METHODS Cost analysis was performed on the 99 patients with ND-CKD and iron-deficiency anemia of the randomized trial by Pisani et al. Human and material resources utilization was recorded during each iron administration. According to study perspective, direct and indirect costs were considered. Costs for each resource unit were taken from official Italian sources. Probabilistic sensitivity analyses were carried out to test the robustness of the results. RESULTS The base case analysis showed an average cost/cycle per patient of € 111 for oral iron and € 1302 for IV iron. Thus, the potential saving was equal to € 1191 per patient/cycle. The sensitivity analysis showed that the most sensitive driver is the time loss by patient and caregivers for the therapy and related-care, followed by the minutes of nursing care and the number of kilometres travelled to reach the referral centre. DISCUSSION This study showed that oral Sucrosomial® iron could offer specific advantages in terms of potential savings, and allowed identifying some implications for future research. Such advantages still persist with the new single dose IV iron formulation available in the market, although to a lesser extent.

中文翻译：

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口服 Sucrosomial® 铁剂与静脉注射铁剂治疗 ND-CKD 患者缺铁性贫血的恢复：成本最小化分析。

背景推荐口服铁剂作为非透析慢性肾病（ND-CKD）患者贫血的一线治疗。Sucrosomial®铁剂是新一代口服铁剂，吸收率高、生物利用度高、副作用发生率低，在替代 ND-CKD 患者缺铁性贫血方面已被证明不逊色于静脉注射（IV）铁剂。除了临床益处外，确定口服铁剂与静脉注射铁剂的总成本比较也很重要。本研究的目的是从意大利社会的角度对口服糖体铁与静脉注射葡萄糖酸铁进行成本最小化分析。方法 对 Pisani 等人随机试验中的 99 名 ND-CKD 合并缺铁性贫血患者进行成本分析。记录每次铁管理期间的人力和物力资源利用情况。根据研究角度，考虑了直接成本和间接成本。每个资源单位的成本均来自意大利官方来源。进行概率敏感性分析以测试结果的稳健性。结果 基本案例分析显示，每位患者口服铁剂的平均成本/周期为 111 欧元，静脉注射铁剂的平均成本为 1302 欧元。因此，每个患者/周期可节省 1191 欧元。敏感性分析显示，最敏感的驱动因素是患者和护理人员在治疗和相关护理方面损失的时间，其次是护理时间和到达转诊中心的行驶公里数。讨论 这项研究表明，口服 Sucrosomial® 铁剂可以在潜在节省方面提供特定的优势，并可以确定对未来研究的一些影响。市场上新的单剂量静脉铁制剂仍然具有这些优点，尽管程度较小。