Evaluating ferric carboxymaltose administration in elderly patients: Clinical outcomes, comparative characteristics in different care settings and cost analysis. A five year study

Background and objective

Iron deficiency anemia is prevalent in the elderly, with ferric carboxymaltose increasingly used for intravenous iron supplementation. Evaluating its safety, efficacy, and cost implications in various care settings is essential. This study assesses the clinical outcomes, adverse reactions, and cost-effectiveness of administering ferric carboxymaltose to elderly patients across different care settings over five years.

Methods

This retrospective observational cohort study included 198 elderly patients who received ferric carboxymaltose at a Geriatric Day Hospital from January 1, 2019, to December 31, 2023. Data on sociodemographic, clinical, and laboratory factors, along with adverse reaction records, were collected. Costs of administration at the Geriatric Day Hospital were compared with hypothetical costs if administered at home or in a nursing home by a Geriatric Home Hospitalization unit.

Results

A total of 279 doses of ferric carboxymaltose were administered. Mean age of 87.3 years, 70% women. Primary indication for treatment was intestinal iron malabsorption (62.7%). Treatment was generally safe, no severe adverse reactions; mild adverse reactions occurred in 5.73% of doses, mainly involving arterial hypo- or hypertension. Patients in nursing homes exhibited higher functional dependence, frailty, and comorbidity compared to those living at home. Cost analysis showed potential savings of €39,353.80 with administration by the Geriatric Home Hospitalization unit, attributed to lower operational and personnel costs.

Conclusions

Ferric carboxymaltose is safe and effective for elderly patients, including those with high frailty and comorbidity. Administering this treatment in home or nursing home settings is cost-effective, potentially enhancing accessibility and reducing overall healthcare costs.