Work

Epidemiology and treatment of patients with iron deficiency and iron deficiency anemia: a study on longitudinal German health claims data

Year: 2025

Type: article

Abstract: BACKGROUND: Iron deficiency (ID) and ID anemia (IDA), the most common deficiency diseases, may occur as isolated diseases or secondary to a causative disorder such as menorrhagia, inflammatory bowel disease (IBD), and heart disease (HD). As real-world data are limited, our objective was to assess the prevalence of ID/IDA, associated comorbidity, drug treatments focusing on trivalent ferric maltol, and healthcare resource utilization (HRU) with associated costs in Germany. METHODS: This retrospective, non-interventional cohort study analyzed anonymized German health claims data covering 2016–2021. Data on patients with ID/IDA and matched control individuals, subgroups of patients with ID/IDA and concurrent disease (menorrhagia, IBD, HD), as well as patients with ID/IDA treated with ferric maltol were descriptively analyzed to evaluate prevalences, comorbidities (Elixhauser Comorbidity Index [ECI]), drug prescriptions, HRU, and HRU-associated costs. RESULTS: In 2021, 129,462 individuals were diagnosed with ID/IDA. Concurrent menorrhagia, IBD, and HD were observed in 34,421, 8,422, and 44,699 individuals, respectively. ID/IDA prevalences were stable throughout the study at approximately 3.3% but were higher in older individuals (up to 10.1%) and women of reproductive age (5.6–7.35%). Comorbidity burden (ECI) was two-fold higher in patients with ID/IDA than in control individuals (4.5 ± 3.6 vs. 2.3 ± 2.5, 2021 [mean ± SD]) and increased with concurrent diseases (menorrhagia [3.4 ± 2.8], IBD [5.0 ± 3.9], HD [7.9 ± 3.5]). The most frequently prescribed medication was oral bivalent iron preparation (25.0–27.5%; parenteral iron: 5.8–6.5%; oral trivalent iron: 0.2–0.7%). Ferric maltol dispensations increased slightly from 2018 to 2021 compared to other trivalent iron preparations. In patients with ID/IDA, the percentages of hospitalizations and sick leaves were higher than in control individuals (41.2% vs. 22.0%; 21.4% vs. 3.1%), corresponding to higher total costs that further increased with concurrent disease. In the subgroup of patients treated with ferric maltol (n = 686), HRU was lower in some parameters, with slightly higher ID/IDA-related total costs. Within 180 days after treatment initiation, most patients continued ferric maltol and did not switch to another iron preparation. CONCLUSIONS: Despite the heterogeneity of the disease, monitoring prevalence of ID/IDA, comorbidities, drug treatments, and HRU may help identify populations at increased health risk to optimize treatment strategies.

Source: BMC Public Health

DOI: 10.1186/s12889-025-24730-9