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Recording available 2/16-5/2

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Poster Session 2

Category: Healthcare Policy/Economics

Poster Session 2

(595) Cost-Effectiveness of Oral vs. IV Iron treatment for Iron Deficiency Anemia in Pregnancy

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Meghana Narahari (she/her/hers)

Medical Student
Oregon Health and Science University
Camas, Washington, United States

Coauthor(s)

Amelia H. Gagliuso, BA (she/her/hers)

Medical Student
Oregon Health and Science University
Portland, Oregon, United States
LB

Lily Ben-Avi, BA

Oregon Health & Science University
Oregon Health & Science University, Oregon, United States
AB

Ashley E. Benson, MD

Oregon Health & Science University
Portland, Oregon, United States
Aaron B. Caughey, MD, PhD

Chair and Professor of Obstetrics and Gynecology
Oregon Health & Science University
Oregon Health & Science University, Oregon, United States

Objective:
Iron deficiency anemia (IDA) in pregnancy is a common condition which affects about 23% of all pregnancies. Increasing severity of IDA is associated with progressively worse maternal and neonatal outcomes. A recent randomized trial found that pregnant patients with IDA treated with intravenous (IV) iron had lower rates of mild, moderate and severe anemia compared to those treated with oral iron. This analysis evaluated the cost-effectiveness of oral ferrous sulfate compared to IV low molecular weight dextran (IV ID) for IDA in pregnancy.

Study Design:
We constructed a decision-analytic model using TreeAge to compare outcomes in pregnant patients with IDA who were treated with IV versus oral iron. The modeled cohort consisted of 842,787 individuals and was calculated based on the prevalence of IDA in pregnancy. Clinical outcomes measured in the model included preeclampsia, stillbirth, preterm birth, neonatal death and neurodevelopmental disability. Probabilities, utilities and costs were derived from literature. QALYs were discounted at a rate of 3%.

Results:
In this theoretical cohort, IV ID was associated with a reduction in 1,294 cases of preeclampsia, 1,760 cases of stillbirth, 12,016 cases of preterm birth, 101 cases of neonatal death and 103 cases of neurodevelopmental delay. IV ID was the dominant strategy as it saved $680,246,993 and resulted in an additional 439,279 QALYs.

Conclusion:
We found that the IV ID strategy resulted in savings of $680,246,993 and 439,279 additional QALYs. Considering the significant decrease in morbidity and cost, the results of our model support the use of IV ID over oral ferrous sulfate.