An economic analysis of anemia prevention during infancy

Area of Science:

• Pediatric Hematology
• Nutritional Anemia
• Biomarker Analysis

Background:

• Iron deficiency is a prevalent concern in infants aged 9-12 months.
• Early detection and treatment of iron deficiency are crucial for preventing long-term health consequences, including neurocognitive delays.
• Current screening methods using hemoglobin (Hb) alone may have limitations in sensitivity for diagnosing iron deficiency.

Purpose of the Study:

• To evaluate the cost-benefit of using reticulocyte hemoglobin content (CHr) versus hemoglobin (Hb) for diagnosing and treating iron deficiency in infants.
• To compare the economic impact of CHr, Hb alone, and complete blood count (CBC) as screening tools.
• To assess the societal perspective on the cost-effectiveness of these diagnostic strategies.

Main Methods:

• Cohort simulations were employed to model the cost-benefit analysis.
• Assumptions included a 9% prevalence of iron deficiency and specific testing characteristics and costs for CHr, Hb, and CBC.
• Costs for iron therapy and potential long-term costs of neurocognitive delays were incorporated.

Main Results:

• The incremental cost to diagnose and treat iron deficiency using CHr, compared to Hb alone, was $22 per patient screened, preventing one case of anemia for every 20 patients treated.
• Over a 10-year period, considering the risks of neurocognitive delays, the CHr strategy cost $280 per case of anemia prevented.
• CHr demonstrated higher sensitivity (83%) compared to Hb (26%) in detecting iron deficiency.

Conclusions:

• Reticulocyte hemoglobin content (CHr) presents an affordable and effective strategy for preventing anemia in infants.
• CHr screening is a valuable tool for early identification of iron deficiency in this age group.
• The findings support the integration of CHr into routine infant screening protocols to mitigate the risks associated with untreated iron deficiency.