To evaluate the impact of budget on the total health care costs of using ferric carboxymaltose to correct iron deficiency anaemia compared with usual care in perioperative anaemia management in general surgery, and to provide a decision-making basis to promote the implementation of patient blood management (PBM) in China, particularly anaemia management focused on rapid and adequate iron supplementation in the perioperative period.

Based on Chinese epidemiological data, the differences in the reduction of allogeneic blood transfusion rate and length of stay in the perioperative period between the PBM group and the conventional treatment group were compared, and an analysis model of impact on budget was constructed combined with domestic cost data. Clinical outcomes were from data of foreign randomized clinical trials, and cost data were from public prices in the domestic market, including iron drug (oral iron, ferric carboxymaltose), injection, EPO use, blood transfusion, and hospitalization.

Based on 3.758 million elective general surgery patients nationwide, the use of ferric carboxymaltose for anaemia management in the perioperative period as a complete substitute for routine care would have prevented 704,690 blood transfusions and saved a total of ￥139 million in treatment costs, with an average saving of ￥42 per patient. A sensitivity analysis showed total treatment cost savings of ￥1.086 billion, ￥2.033 billion, ￥2.981 billion and ￥3.928 billion assuming a 10%, 20%, 30% and 40% reduction in the price of ferric carboxymaltose, with average cost savings per patient being ￥289, ￥541, ￥793 and ￥1 045, respectively.

It is recommended that the patients with clinical perioperative iron deficiency anaemia undergo implementation of patient blood management and that ferric carboxymaltose be used for anaemia management.