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首页> 外文期刊>ClinicoEconomics and Outcomes Research >Oral versus intravenous iron therapy in patients with inflammatory bowel disease and iron deficiency with and without anemia in Germany – a real-world evidence analysis
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Oral versus intravenous iron therapy in patients with inflammatory bowel disease and iron deficiency with and without anemia in Germany – a real-world evidence analysis

机译：在德国，有和没有贫血的炎症性肠病和铁缺乏症患者口服铁剂与静脉铁剂治疗–真实证据分析

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Background: Iron-deficiency anemia and iron deficiency are common comorbidities associated with inflammatory bowel disease (IBD) resulting in impaired quality of life and high health care costs. Intravenous iron has shown clinical benefit compared to oral iron therapy. Aim: This study aimed to compare health care outcomes and costs after oral vs intravenous iron treatment for IBD patients with iron deficiency or iron deficiency anemia (ID/A) in Germany. Methods: IBD patients with ID/A were identified by ICD-10-GM codes and newly commenced iron treatment via ATC codes in 2013 within the InGef (formerly Health Risk Institute) research claims database. Propensity score matching was performed to balance both treatment groups. Non-observable covariates were adjusted by applying the difference-in-differences (DID) approach. Results: In 2013, 589 IBD patients with ID/A began oral and 442 intravenous iron treatment. After matching, 380 patients in each treatment group were analyzed. The intravenous group had fewer all-cause hospitalizations (37% vs 48%) and ID/A-related hospitalizations (5% vs 14%) than the oral iron group. The 1-year preobservation period comparison revealed significant health care cost differences between both groups. After adjusting for cost differences by DID method, total health care cost savings in the intravenous iron group were calculated to be €367. While higher expenditure for medication (€1,876) was observed in the intravenous iron group, the inpatient setting achieved most cost savings (€1,887). Conclusion: IBD patients receiving intravenous iron were less frequently hospitalized and incurred lower total health care costs compared to patients receiving oral iron. Higher expenditures for pharmaceuticals were compensated by cost savings in other domains.
机译：背景：缺铁性贫血和缺铁是与炎症性肠病（IBD）相关的常见合并症，导致生活质量下降和医疗费用高昂。与口服铁疗法相比，静脉铁已显示出临床益处。目的：本研究旨在比较德国针对患有铁缺乏症或铁缺乏性贫血（ID / A）的IBD患者进行口服铁剂治疗与静脉铁剂治疗后的医疗效果和费用。方法：2013年，在InGef（以前的健康风险研究所）研究声明数据库中，通过ICD-10-GM代码识别了IBD的ID / A患者，并通过ATC代码重新开始了铁剂治疗。进行倾向得分匹配以平衡两个治疗组。不可观察的协变量通过应用差异差异（DID）方法进行调整。结果：2013年，有589名ID / A的IBD患者开始口服和442例静脉铁剂治疗。匹配后，对每个治疗组的380名患者进行了分析。静脉注射组的全因住院率（37％比48％）和ID / A相关的住院率（5％vs 14％）要少于口服铁剂组。观察前1年的比较显示两组之间的医疗保健费用存在显着差异。通过DID方法调整费用差异后，静脉铁剂组的总医疗费用节省量为367欧元。静脉铁剂组的药物治疗费用较高（€1,876），而住院患者节省的费用最多（€1,887）。结论：与接受口服铁剂的患者相比，接受静脉铁剂的IBD患者住院频率更低，总医疗保健费用更低。药品支出的增加被其他领域的成本节省所弥补。

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