# Four oral iron supplements for treating iron-deficiency anemia during pregnancy in China: a cost-effectiveness and budget analysis

## TL;DR

This study compares the cost-effectiveness of four oral iron supplements for treating anemia in pregnant women in China and evaluates the financial impact of adding one to the national drug list.

## Contribution

The study introduces a cost-effectiveness and budget analysis of four iron supplements for anemia in pregnancy in China.

## Key findings

- Ferrous succinate sustained-release tablets are a cost-effective treatment option for iron-deficiency anemia during pregnancy.
- Adding ferrous succinate to the NRDL could reduce total medical insurance expenditures for treating anemia in pregnant women.
- The additional cost per effect of ferrous succinate compared to polysaccharide-iron complex capsules is $3.23.

## Abstract

This study has two primary objectives: (a) to conduct a comparative cost-effectiveness analysis of four commonly used oral iron supplements for treating iron-deficiency anemia during pregnancy in China, including ferrous succinate sustained-release tablets, polysaccharide-iron complex capsules, iron protein succinylate oral solution, and iron dextran oral solution; and (b) to assess the budget impact of including ferrous succinate sustained-release tablets in the National Reimbursement Drug List (NRDL) on national medical insurance expenditures.

A decision tree model was developed to analyze the cost-effectiveness based on treatment efficacy derived from a network meta-analysis. A sensitivity analysis was conducted to address uncertainties in the parameters. Subsequently, a budget impact analysis model was utilized to calculate the effect of including ferrous succinate sustained-release tablets in the NRDL on the expenditures of employee medical insurance funds, resident medical insurance funds, and the total medical insurance fund expenditures.

The cost-effectiveness analysis showed that ferrous succinate sustained-release tablets are a cost-effective treatment option. When compared to polysaccharide-iron complex capsules, the additional cost per effect of the ferrous succinate sustained-release tablets is $3.23. If these tablets are included in the NRDL, the total medical insurance expenditure on oral iron preparations for treating iron-deficiency anemia in pregnant women is expected to decrease from $160.14 million to $156.82 million between 2025 and 2027.

Ferrous succinate sustained-release tablets are a cost-effective treatment option for iron-deficiency anemia during pregnancy in China.