A recent study found that identifying and treating women with iron deficiency at a ferritin threshold of less than 25µg/L is a cost-effective intervention. The results were presented at the ASH Annual Meeting.
“Iron deficiency is the most common micronutrient deficiency globally and one of the top five causes of years lived with disability in every country around the world. Epidemiologically, this health burden disproportionately affects persons with the capacity to menstruate. If unaddressed, iron deficiency may progress to iron-deficiency anemia, further impacting the social, emotional, and health-related well-being of affected individuals,” wrote the authors, led by Daniel Wang of Yale School of Medicine in New Haven, Connecticut.
The authors explained that iron deficiency is underdiagnosed and undertreated in the US, citing a lack of universal screening and low diagnostic thresholds. Current guidelines use 15µg/L as the threshold, per the Centers for Disease Control and Prevention and the World Health Organization.
The researchers performed a cost-effectiveness analysis involving adult women to identify an ideal ferritin threshold for the diagnosis and treatment of iron deficiency. They tested ferritin threshold less than 25µg/L, ferritin threshold less than 15µg/L, and no screening. When a woman was found to be iron deficient, she was treated with iron supplementation, followed up with hematology, and received retreatment until age 51, the median age of menopause in the United States. The researchers assessed quality-adjusted life-years (QALYs) and the incremental cost-effectiveness of screening versus no screening.
The study found that screening for iron deficiency at a ferritin threshold of less than 25µg/L was the most cost-effective strategy. It cost $212,000 and generated 24.3 QALYs, compared with $211,000 and 23.3 QALYs at the threshold of 15µg/L and $210,000 and 22.3 QALYs with no screening. The difference between less than 25µg/L versus no screening equals an incremental cost-effectiveness ratio of $940/QALY, which the researchers said is “well under all accepted willingness-to-pay thresholds.
“These results fill a critical gap in women’s health and align with a priority area (i.e., iron deficiency) for the American Society of Hematology,” the authors concluded.
https://ash.confex.com/ash/2024/webprogram/Paper203654.html
Reference
Wang D, Glaeser-Khan S, Wang DY, et al. Sex, lies, and iron deficiency in 2024: cost-effectiveness of screening ferritin thresholds for the treatment of iron deficiency in women of reproductive age. Abstract #277. Presented at the 66th American Society of Hematology Annual Meeting and Exposition; December 7–10, 2024; San Diego, California.
