| Title: |
Cost-effectiveness of first-line IV vs oral iron for iron-deficiency anemia in women with heavy menstrual bleeding |
| Authors: |
Daniel Wang; Manraj Sra; Satoko Ito; Ding Quan Ng; Samira Glaeser-Khan; Daniel Y. Wang; Sam Hirniak; Alfred Ian Lee; Adam Cuker; George Goshua |
| Source: |
Blood Advances, Vol 10, Iss 5, Pp 1508-1517 (2026) |
| Publisher Information: |
Elsevier, 2026. |
| Publication Year: |
2026 |
| Collection: |
LCC:Specialties of internal medicine |
| Subject Terms: |
Specialties of internal medicine; RC581-951 |
| Description: |
Abstract: Iron-deficiency anemia (IDA) affects nearly one-third of women globally, with heavy menstrual bleeding (HMB) being a significant risk factor among those of reproductive age. Despite the substantial burden of HMB-related IDA, patients often face delays in receiving effective treatment. Oral iron is typically used as first-line therapy, despite frequent gastrointestinal side effects and challenges in treatment adherence. This study evaluated the reproductive life span cost-effectiveness of first-line intravenous (IV) vs oral iron therapy for women with HMB and IDA. We developed a Markov model simulating a cohort of women aged 18 to 51 years, comparing first-line treatment with IV iron dextran, IV ferumoxytol, IV iron sucrose, or oral ferrous sulfate. Costs and quality-adjusted life years (QALYs) were estimated from the societal perspective. IV iron dextran was the cost-effective treatment, yielding 19.26 QALYs at a cost of $157 500, compared with 19.10 QALYs at $152 900 for oral ferrous sulfate. The incremental cost-effectiveness ratio for IV iron dextran was $28 600 per QALY. Treatment with IV ferumoxytol and iron sucrose cost $158 300 and $163 500, respectively, and did not provide additional QALY benefit compared with IV iron dextran, which remained the cost-effective treatment across a range of scenarios and sensitivity analyses. Our findings indicate that first-line treatment with IV iron dextran is the cost-effective strategy for managing IDA in women with HMB at commonly accepted willingness-to-pay thresholds. These results support expanding access to IV iron as a first-line option, and highlight the need to reduce treatment delays and insurance-related barriers. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2473-9529 |
| Relation: |
http://www.sciencedirect.com/science/article/pii/S247395292600011X; https://doaj.org/toc/2473-9529 |
| DOI: |
10.1182/bloodadvances.2025018315 |
| Access URL: |
https://doaj.org/article/b8ffbf6ccdf74c49b025ddc77b17ff3d |
| Accession Number: |
edsdoj.b8ffbf6ccdf74c49b025ddc77b17ff3d |
| Database: |
Directory of Open Access Journals |