| Coverage Policy Manual | |
| Policy #: | 1997153 |
| Category: | Pharmacy |
| Initiated: | November 1993 |
| Last Review: | January 2024 |
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| Iron Therapy, Parenteral | |
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| Description: |
Parenteral iron therapy is indicated in individuals with iron deficiency anemia associated with conditions that interfere with the ingestion or absorption of oral iron. Failure to respond to oral iron therapy does not automatically recommend parenteral iron therapy.
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Policy/ Coverage: |
The following iron preparations are non-covered. See statements of non-coverage below.
The Step Therapy Medication Act is applicable to fully insured (Arkansas Blue Cross, Health Advantage, and Exchange) and specified governmental (ASE/PSE and ASP) health plans. The law is not applicable to FEP or self-insured ERISA groups (including but not limited to Walmart or other Blue Advantage groups). Initial approval for exigent request is 28 days. Otherwise, initial approval for standard review is up to 1 year.
Effective March 6, 2024
Meets Primary Coverage Criteria Or Is Covered For Contracts Without Primary Coverage Criteria
Parenteral iron for the treatment of iron deficiency anemia meets member benefit certificate primary coverage criteria for:
*Continued administration is allowed provided documentation of persistent anemia and ferritin less than 100 mg/ml (ferritin less than 500 mg/ml for ESRD).
Please refer to a separate policy on Site of Care or Site of Service Review (policy #2018030) for pharmacologic/biologic medications.
Does Not Meet Primary Coverage Criteria Or Is Investigational For Contracts Without Primary Coverage Criteria
Parenteral iron therapy, for any indication or circumstance not described above, does not meet member benefit certificate primary coverage criteria that there be scientific evidence of effectiveness in improving health outcomes.
For contracts without primary coverage criteria, parenteral iron therapy, for any indication or circumstance not described above, is considered investigational. Investigational services are considered contract exclusions in most member benefit certificates of coverage.
The use of ferric carboxymaltose (e.g., Injectafer) and ferric derisomaltose (e.g., Monoferric) as parenteral iron therapy for any indication does not meet member benefit certificate primary coverage criteria because there is a lack of data indicating this intervention is more effective than other interventions that are less costly.
For members with contracts without primary coverage criteria, ferric carboxymaltose (e.g., Injectafer) and ferric derisomaltose (e.g., Monoferric) as parenteral iron therapy for any indication is considered not medically necessary. Services that are considered not medically necessary are specific contract exclusions in most member benefit certificates of coverage.
Effective January 10, 2024 to March 5, 2024
Meets Primary Coverage Criteria Or Is Covered For Contracts Without Primary Coverage Criteria
Parenteral iron for the treatment of iron deficiency anemia meets member benefit certificate primary coverage criteria for:
*Continued administration is allowed provided documentation of persistent anemia and ferritin less than 100 mg/ml (ferritin less than 500 mg/ml for ESRD).
Please refer to a separate policy on Site of Care or Site of Service Review (policy #2018030) for pharmacologic/biologic medications.
Does Not Meet Primary Coverage Criteria Or Is Investigational For Contracts Without Primary Coverage Criteria
Parenteral iron therapy, for any indication or circumstance not described above, does not meet member benefit certificate primary coverage criteria that there be scientific evidence of effectiveness in improving health outcomes.
For contracts without primary coverage criteria, parenteral iron therapy, for any indication or circumstance not described above, is considered investigational. Investigational services are considered contract exclusions in most member benefit certificates of coverage.
The use of ferric carboxymaltose (e.g., Injectafer) and ferric derisomaltose (e.g., Monoferric) as parenteral iron therapy for any indication does not meet member benefit certificate primary coverage criteria because there is a lack of data indicating this intervention is more effective than other interventions that are less costly.
For members with contracts without primary coverage criteria, ferric carboxymaltose (e.g., Injectafer) and ferric derisomaltose (e.g., Monoferric) as parenteral iron therapy for any indication is considered not medically necessary. Services that are considered not medically necessary are specific contract exclusions in most member benefit certificates of coverage.
Effective November 2020 to January 9, 2024
Meets Primary Coverage Criteria Or Is Covered For Contracts Without Primary Coverage Criteria
Parenteral iron for the treatment of iron deficiency anemia meets member benefit certificate primary coverage criteria for:
Please refer to a separate policy on Site of Care or Site of Service Review (policy #2018030) for pharmacologic/biologic medications.
Does Not Meet Primary Coverage Criteria Or Is Investigational For Contracts Without Primary Coverage Criteria
Parenteral iron therapy does not meet member benefit certificate primary coverage criteria that there be scientific evidence of effectiveness if oral iron therapy fails due to any of the following circumstances:
For contracts without primary coverage criteria, parenteral iron therapy is considered investigational if oral iron therapy fails due to any of the circumstances listed above. Investigational services are considered contract exclusions in most member benefit certificates of coverage.
Parenteral iron therapy does not meet member benefit certificate primary coverage criteria that there be scientific evidence of effectiveness in improving health outcomes for the treatment of fatigue in non-anemic individuals.
For contracts without primary coverage criteria, parenteral iron therapy for the treatment of fatigue in non-anemic patients is considered investigational. Investigational services are considered contract exclusions in most member benefit certificates of coverage.
The use of ferric carboxymaltose (e.g., Injectafer) as parenteral iron therapy for any indication does not meet member benefit certificate primary coverage criteria because there is a lack of data indicating this intervention is more effective than other interventions that are less costly.
For members with contracts without primary coverage criteria, ferric carboxymaltose (e.g., Injectafer) as parenteral iron therapy for any indication is considered not medically necessary. Services that are considered not medically necessary are specific contract exclusions in most member benefit certificates of coverage
The use of ferric pyrophosphate citrate (e.g., Triferic) does not meet member benefit certificate primary coverage criteria because there is a lack of data indicating this intervention is more effective than other interventions that are less costly.
For members with contracts without primary coverage criteria, ferric pyrophosphate citrate (e.g., Triferic) as parenteral iron therapy for any indication is considered not medically necessary. Services that are considered not medically necessary are specific contract exclusions in most member benefit certificates of coverage
The use of ferric derisomaltose (e.g., Monoferric) does not meet member benefit certificate primary coverage criteria because there is a lack of data indicating this intervention is more effective than other interventions that are less costly.
For members with contracts without primary coverage criteria, ferric derisomaltose (e.g., Monoferric) as parenteral iron therapy for any indication is considered not medically necessary. Services that are considered not medically necessary are specific contract exclusions in most member benefit certificates of coverage.
Effective October 2020
Meets Primary Coverage Criteria Or Is Covered For Contracts Without Primary Coverage Criteria
Parenteral iron for the treatment of iron deficiency anemia meets member benefit certificate primary coverage criteria for:
1. Iron Deficiency Anemia defined as a Hgb < 13 gm/dl for men or Hgb < 12 gm/dl for women with:
a) Ferritin < or equal to 40 ng/ml adults, children, and pregnant women; OR
b) Ferritin < or equal 100 ng/ml for members with documented active liver disease, chronic systemic infection, advanced malignancy, or uncontrolled systemic inflammatory state (e.g. active rheumatoid arthritis, active inflammatory bowel disease, etc), gastrointestinal malabsorption disorders, post gastrointestinal resection or bypass; OR
c) Transferrin saturation <16 percent or <20 percent in individuals with inflammatory conditions OR
d) End-Stage Renal Disease (ESRD)/Chronic Renal Failure on dialysis with ferritin < 500 or percent transferrin saturation (tsat) < 30% (in accordance with National Kidney Foundation guidelines). (Revised 3/31/2015)
AND
2. One of the following documented problems:
a) Unable to tolerate oral iron; OR
b) Fail to respond to oral iron despite an adequate supervised trial (at least 4 wks); OR
c) Presence of medically or surgically uncorrectable condition causing iron deficiency not amenable to oral therapy (e.g. gastric bypass, active inflammatory bowel disease, ESRD, excessive continuing blood loss, severe iron deficiency anemia in pregnancy, etc)
*Continued administration is allowed provided documentation of persistent anemia and ferritin < 100 ng/ml (ferritin < 500ng/ml for ESRD).
Please refer to a separate policy on Site of Care or Site of Service Review (policy #2018030) for pharmacologic/biologic medications.
Does Not Meet Primary Coverage Criteria Or Is Investigational For Contracts Without Primary Coverage Criteria
Parenteral iron therapy does not meet member benefit certificate primary coverage criteria that there be scientific evidence of effectiveness if oral iron therapy fails due to any of the following circumstances:
For contracts without primary coverage criteria, parenteral iron therapy is considered investigational if oral iron therapy fails due to any of the circumstances listed above. Investigational services are considered contract exclusions in most member benefit certificates of coverage.
Parenteral iron therapy does not meet member benefit certificate primary coverage criteria that there be scientific evidence of effectiveness in improving health outcomes for the treatment of fatigue in non-anemic patients.
For contracts without primary coverage criteria, parenteral iron therapy for the treatment of fatigue in non-anemic patients is considered investigational. Investigational services are considered contract exclusions in most member benefit certificates of coverage.
The use of ferric carboxymaltose (Injectafer) as parenteral iron therapy for any indication does not meet member benefit certificate primary coverage criteria of cost effectiveness because there is a there is a lack of data indicating this intervention is more effective than other interventions that are less costly.
For members with contracts without primary coverage criteria, the use of ferric carboxymaltose (Injectafer) as parenteral iron therapy for any indication is considered not medically necessary. Services that are considered not medically necessary are specific contract exclusions in most member benefit certificates of coverage.
The use of ferric pyrophosphate citrate (Triferic) as parenteral iron therapy for any indication does not meet member benefit certificate primary coverage criteria of cost effectiveness because there is a there is a lack of data indicating this intervention is more effective than other interventions that are less costly.
For members with contracts without primary coverage criteria, the use of pyrophosphate citrate (Triferic) as parenteral iron therapy for any indication is considered not medically necessary. Services that are considered not medically necessary are specific contract exclusions in most member benefit certificates of coverage.
The use of ferric derisomaltose (Monoferric) as parenteral iron therapy for any indication does not meet member benefit certificate primary coverage criteria of cost effectiveness because there is a there is a lack of data indicating this intervention is more effective than other interventions that are less costly.
For members with contracts without primary coverage criteria, the use of ferric derisomaltose (Monoferric) as parenteral iron therapy for any indication is considered not medically necessary. Services that are considered not medically necessary are specific contract exclusions in most member benefit certificates of coverage.
Effective January 2020 to September 2020
Meets Primary Coverage Criteria Or Is Covered For Contracts Without Primary Coverage Criteria
Parenteral iron for the treatment of iron deficiency anemia meets member benefit certificate primary coverage criteria for:
AND
2. One of the following documented problems:
a) Unable to tolerate oral iron; OR
b) Fail to respond to oral iron despite an adequate supervised trial (at least 4 wks); OR
c) Presence of medically or surgically uncorrectable condition causing iron deficiency not amenable to oral therapy (e.g. gastric bypass, active inflammatory bowel disease, ESRD, excessive continuing blood loss, severe iron deficiency anemia in pregnancy, etc)
*Continued administration is allowed provided documentation of persistent anemia and ferritin < 100 ng/ml (ferritin < 500ng/ml for ESRD).
Please refer to a separate policy on Site of Care or Site of Service Review (policy #2018030) for pharmacologic/biologic medications.
Does Not Meet Primary Coverage Criteria Or Is Investigational For Contracts Without Primary Coverage Criteria
Parenteral iron therapy does not meet member benefit certificate primary coverage criteria that there be scientific evidence of effectiveness if oral iron therapy fails due to any of the following circumstances:
For contracts without primary coverage criteria, parenteral iron therapy is considered investigational if oral iron therapy fails due to any of the circumstances listed above. Investigational services are considered contract exclusions in most member benefit certificates of coverage.
Parenteral iron therapy does not meet member benefit certificate primary coverage criteria that there be scientific evidence of effectiveness in improving health outcomes for the treatment of fatigue in non-anemic patients.
For contracts without primary coverage criteria, parenteral iron therapy for the treatment of fatigue in non-anemic patients is considered investigational. Investigational services are considered contract exclusions in most member benefit certificates of coverage.
The use of ferric carboxymaltose (Injectafer) as parenteral iron therapy for any indication does not meet member benefit certificate primary coverage criteria of cost effectiveness because there is a there is a lack of data indicating this intervention is more effective than other interventions that are less costly.
For members with contracts without primary coverage criteria, the use of ferric carboxymaltose (Injectafer) as parenteral iron therapy for any indication is considered not medically necessary. Services that are considered not medically necessary are specific contract exclusions in most member benefit certificates of coverage.
Effective April 2015 to December 2019
Meets Primary Coverage Criteria Or Is Covered For Contracts Without Primary Coverage Criteria
Parenteral iron for the treatment of iron deficiency anemia meets member benefit certificate primary coverage criteria for:
a) Ferritin < or equal to 40 ng/ml adults, children, and pregnant women; OR
b) Ferritin < or equal 100 ng/ml for members with documented active liver disease, chronic systemic infection, advanced malignancy, or uncontrolled systemic inflammatory state (e.g. active rheumatoid arthritis, active inflammatory bowel disease, etc); OR
c) Transferrin saturation <16 percent or <20 percent in individuals with inflammatory conditions OR
d) End-Stage Renal Disease (ESRD)/Chronic Renal Failure on dialysis with ferritin < 500 or percent transferrin saturation (tsat) < 30% (in accordance with National Kidney Foundation guidelines). (Revised 3/31/2015)
AND
2. One of the following documented problems:
a) Unable to tolerate oral iron; OR
b) Fail to respond to oral iron despite an adequate supervised trial (at least 4 wks); OR
c) Presence of medically or surgically uncorrectable condition causing iron deficiency not amenable to oral therapy (e.g. gastric bypass, active inflammatory bowel disease, ESRD, excessive continuing blood loss, severe iron deficiency anemia in pregnancy, etc)
*Continued administration is allowed provided documentation of persistent anemia and ferritin < 100 ng/ml (ferritin < 500ng/ml for ESRD).
Does Not Meet Primary Coverage Criteria Or Is Investigational For Contracts Without Primary Coverage Criteria
Parenteral iron therapy does not meet member benefit certificate primary coverage criteria that there be scientific evidence of effectiveness if oral iron therapy fails due to any of the following circumstances:
For contracts without primary coverage criteria, parenteral iron therapy is considered investigational if oral iron therapy fails due to any of the circumstances listed above. Investigational services are considered contract exclusions in most member benefit certificates of coverage.
Parenteral iron therapy does not meet member benefit certificate primary coverage criteria that there be scientific evidence of effectiveness in improving health outcomes for the treatment of fatigue in non-anemic patients.
For contracts without primary coverage criteria, parenteral iron therapy for the treatment of fatigue in non-anemic patients is considered investigational. Investigational services are considered contract exclusions in most member benefit certificates of coverage.
The use of ferric carboxymaltose (Injectafer) as parenteral iron therapy for any indication does not meet member benefit certificate primary coverage criteria of cost effectiveness because there is a there is a lack of data indicating this intervention is more effective than other interventions that are less costly.
For members with contracts without primary coverage criteria, the use of ferric carboxymaltose (Injectafer) as parenteral iron therapy for any indication is considered not medically necessary. Services that are considered not medically necessary are specific contract exclusions in most member benefit certificates of coverage.
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| Rationale: |
The majority of patients are able to tolerate oral iron therapy without difficulty. Perhaps 10-20% of patients may have symptoms, usually gastrointestinal, attributable to oral iron. Parenteral iron therapy, with the risk of adverse reactions, should be reserved for the exceptional patient who remains intolerant of oral iron therapy despite repeated modifications in the dosing regimen.
A screening test for iron malabsorption is the administration to the fasting patient of 100 mg of elemental iron as ferrous sulfate in a liquid preparation, followed by measurements of plasma iron concentrations 1 and then 2 hours later. In an iron-deficient patient with an initial plasma iron concentration less than 50 mg/dL, an increase in plasma iron concentration of 200 to 300 mg/dL is expected. An increase in plasma iron concentration less than 100 mg/dL suggests malabsorption and is an indication for a small-bowel biopsy (Cook & Hoffman).
There is a theory that inflammatory cytokines (tumor necrosis factor, interleukin, interferon) create a block in iron delivery from the reticuloendothelial system. There is one randomized controlled trial that addresses the question of whether patients with anemia associated with malignancy, but with apparent normal iron stores, benefit from the administration of intravenous iron along with administration of epoetin. A randomized controlled trial (Auerbach, 2004) compared patients treated with no iron, IV iron, and oral iron, and although each group showed improvement in hemoglobin level, the group receiving IV iron improved the most. There also has been criticism of the methodology of this paper, and subsequent reviews of this subject have stated that more investigation of is needed; in addition, the paper was sponsored by the manufacturer of an IV iron preparation, and neither the patients nor the investigators were not blinded to the therapy.
A prospective, randomized, controlled, open labeled, multicenter trial (Henry, 2007) compared epoetin alfa with either no iron, oral iron or IV iron over an eight week period. This studied should an increase in mean Hb in all groups thought the IV iron group showed the greatest increase. Several criticisms of this paper include the short iron treatment time (8 weeks as compared to 12 weeks) which may have be insufficient time for oral iron improvements to b e detected. Also, there was a significant difference in patient s assigned to the IV iron group and oral iron group. The IV iron group had a greater number of breast cancer patients while the oral iron group had a greater number of colorectal cancers. Those with colorectal cancer would be more likely to have iron deficiency than would patients with breast cancer. The study also included patients with normal iron stores. This study was sponsored by the company that supplied the IV iron and several authors were paid consultants for the sponsoring company. Neither investigators nor patients were blinded to the therapy.
The 2007 edition of AHFS Drug Compendia had the following information and is unchanged in the 2010 edition:
“There are relatively few indications for parenteral iron therapy. Occasionally, however, parenteral administration may be required in iron-deficient patients in whom oral administration of iron is infeasible or ineffective because of intolerance, poor absorption, GI disease, refusal or inability to take the oral medication, or when rapid replenishment of iron stores is necessary as in hypochromic anemia of infancy or the last trimester of pregnancy. In addition, most chronic renal failure patients who received therapy with epoetin alfa will require oral or parenteral iron therapy because of the dramatic decrease in iron stores associated with erythrocyte formation.
“Since parenteral use of complexes of iron and carbohydrates has resulted in fatal anaphylactoid reactions, iron dextran should be used only in patients in whom a clearly established indication for parenteral iron therapy exists, confirmed by appropriate laboratory tests." (Italics, original).
“The hematologic response to parenterally administered iron dextran is no more rapid than to orally administered iron salts in patients in whom oral iron is effective. The response to iron dextran is also quantitatively similar to that produced by other iron preparations administered parenterally.”
2012 Update
This policy is being updated after a review of the relevant published literature identified in a search of the MEDLINE database. A randomized, double-blind, placebo-controlled study to investigate the effect of parenteral iron to treat fatigue in nonanemic patients was identified (Krayenbuehl, 2011). In this study, 90 premenopausal women, presenting with fatigue with serum ferritin less than or equal to 50ng/ml and hemoglobin greater than or equal to 120 g/L were randomized to receive intravenous iron or placebo. The authors report that after 6 weeks, fatigue decreased in the group treated with iron by 1.1 compared with 0.7 in those treated with placebo (P=.07). In patients with serum ferritin less than 5ng/ml, fatigue decreased by 1.8 in the iron group compared with 0.4 in the placebo group (p=.005). In an accompanying editorial, Drygalski and Adamson conclude, “Given the numbers of women who are iron deficient, the findings could find broad application, but work needs to be done to refine the approach to this common problem” (Drygalski, 2011). According to Drygalski and Adamson, this study raises several questions including the dosage of iron needed to see these effects as well as the route of administration (parenteral versus oral). Further studies are needed to answer these and other questions regarding the use of parenteral iron in the treatment of fatigue in nonanemic patients.
2013 Update
The policy is updated with a literature search through May 2013. The coverage statement has been revised to include separate ferritin requirements for adults, children and pregnant women; individuals with active inflammatory states (e.g. rheumatoid arthritis, inflammatory bowel disease); and individuals with end-stage renal disease/chronic renal failure.
2016 Update
A literature search conducted through April 2016 did not reveal any new information that would prompt a change in the coverage statement.
2017 Update
A literature search conducted using the MEDLINE database through April 2017 did not reveal any new information that would prompt a change in the coverage statement.
2019 Update
Annual policy review completed with a literature search using the MEDLINE database through December 2018. No new literature was identified that would prompt a change in the coverage statement.
2020 Update
A literature search conducted through January 2020 did not reveal any new information that would prompt a change in the coverage statement.
2021 Update
Annual policy review completed with a literature search using the MEDLINE database through January 2021. No new literature was identified that would prompt a change in the coverage statement.
2022 Update
Annual policy review completed with a literature search using the MEDLINE database through January 2022. No new literature was identified that would prompt a change in the coverage statement.
2023 Update
Annual policy review completed with a literature search using the MEDLINE database through January 2023. No new literature was identified that would prompt a change in the coverage statement.
2024 Update
Annual policy review completed with a literature search using the MEDLINE database through January 2024. No new literature was identified that would prompt a change in the coverage statement.
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| References: |
Alleyne M, Horne MK, Miller JL.(2008) Individualized treatment for iron-deficiency anemia in adults. Am J Med, 2008; 121(11):943-8. Auerbach M, Ballard H, et al.(2004) Intravenous iron optimizes the response to recombinant human erythropoietin in cancer patients with chemotherapy-related anemia: a multicenter, open-label, randomized trial. J Clin Oncol, 2004; 22:1301-7. Auerbach, M. and Adamson, J.W.(2016) How we diagnose and treat iron deficiency anemia. Am. J. Hematol., 91: 31-38. https://doi.org/10.1002/ajh.24201 Camaschella C.(2015) Iron-deficiency anemia. N Engl J Med. 2015 May;372(19):1832-43. Cappellini MD, Musallam KM, Taher AT.(2020) Iron deficiency anaemia revisited. J Intern Med. 2020;287(2):153-170. doi:10.1111/joim.13004 Clucas D, Brittenham G, Pasricha SR.(2021) Clinical Practice Guidelines on the Gastrointestinal Evaluation of Iron Deficiency Anemia. Gastroenterology. 2021;160(7):2618-2620. doi:10.1053/j.gastro.2020.10.062 Cook JD.(1982) Clinical evaluation of iron deficiency. Semin Hematol. 1982 Jan;19(1):6-18. PMID: 6763340. Cook JD.(1982) Clinical evaluation of iron deficiency. Semin Hematol. 1982;19(1):6-18. Cook JD.(1987) Iron deficiency anemia. Curr Ther Hematol Oncol, 1987; 3:9. Current AHFS Current AHFS. Fernandez-Rodriquez AM, Guindeo-Casasus MC, Molero-Labarta T, et al.(1999) Diagnosis of iron deficiency in chronic renal failure. Am J Kidney Dis. 1999;34(3):508-13. Goldman.(2007) Microcytic and hypochromic anemias. Cecil Medicine, 23rd ed, 2007:Saunders. Guyatt GH, Oxman AD, et al.(1992) Laboratory diagnosis of iron-deficiency anemia: an overview. J Gen Intern Med, 1992; 7(2):145-53. Henry DH, Dahl NV, et al.(2007) Intravenous ferric gluconate significantly improves response to epoetin alfa versus oral iron or no iron in anemic patients with cancer receiving chemotherapy. Oncologist, 2007; 12(2):231-42. Hoffman.(2005) Iron deficiency. Hematology: Basic Principles and Practice, 4th ed., © 2005 Churchill Livingstone. Kalra PR, Cleland JGF, Petrie MC, et.al.(2022) Intravenous ferric derisomaltose in patients with heart failure and iron deficiency in the UK (IRONMAN): an investigator-initiated, prospective, randomised, open-label, blinded-endpoint trial. . Lancet. 2022 Dec 17;400(10369):2199-2209. doi: 10.1016/S0140-6736(22)02083-9. Epub 2022 Nov 5. PMID: 36347265. Krayenbuehl PA, Battegay E, Bremann C, et al.(2011) Intravenous iron for the treatment of fatigue in nonanemic, premenopausal women with low serum ferritin concentration. Blood. 2011 Sep 22;118(12):3222-7. Epub 2011 Jun 24. Kshirsagar AV, Freburger JK, Ellis AR, et al.(2013) The comparative short-term effectiveness of iron dosing and formulations in US hemodialysis patients. Am J Med. 2013 Jun; 126(6):.31-541. Epub 2013 Apr 15. Mast AE, Blinder MA, Gronowski AM, et al.(1998) Clinical utility of the soluble transferrin receptor and comparison with serum ferritin in several populations. Clinical Chemistry. 1998;44(1):45-51. Mikhail A, Brown C, Williams JA, et al.(2017) Renal Association Clinical Practice Guideline – Anaemia of Chronic Kidney Disease – June 2017 https://ukkidney.org/sites/renal.org/files/Updated-130220-Anaemia-of-Chronic-Kidney-Disease-1-1.pdf National Kidney Foundation.(2007) National Kidney Foundation: KDOQI clinical practice guideline and clinical practice recommendations for anemia in chronic kidney disease: 2007 update hemoglobin target. Am J Kidney Dis, 2007; 50(3):471-530. Onken JE, Bregman DB, Harrington RA, et al.(2013) A multicenter, randomized, active-controlled study to investigate the efficacy and safety of intravenous ferric carboxymaltose in patients with iron deficiency anemia. Transfusion. 2014 Feb;54(2):306-15. doi: 10.1111/trf.12289. Epub 2013 Jun 17. PMID: 23772856. Pedrazzoli P, Tullio C, et al.(2004) Iron supplement in cancer patients receiving erythropoietin. J Clin Oncol, 2004:22:4428-9. Punnonen K, Irjala K, Rajamäki.(1997) Serum transferrin receptor and its ratio to serum ferritin in the diagnosis of iron deficiency. Blood. 1997;89(3):1052-1057. Salah HM, Savarese G, Rosano GMC, Ambrosy AP, Mentz RJ, Fudim M.(2023) Intravenous iron infusion in patients with heart failure: a systematic review and study-level meta-analysis. ESC Heart Fail. 2023 Apr;10(2):1473-1480. doi: 10.1002/ehf2.14310. Epub 2023 Feb 2. PMID: 36734033; PMCID: PMC10053151. Schrier SL.(2018) Causes and diagnosis of iron deficiency and iron deficiency anemia in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com (Accessed on January 19, 2018.) Song Z, Tang M, Tang G, Fu G, Ou D, Yao F, Hou X, Zhang D.(2022) Oral iron supplementation in patients with heart failure: a systematic review and meta-analysis. ESC Heart Fail. 2022 Oct;9(5):2779-2786. doi: 10.1002/ehf2.14020. Epub 2022 Jun 27. PMID: 35758130; PMCID: PMC9715811. Von Drygalski A, Adamson JW.(2011) Ironing out fatigue. Blood. 2011 Sep 22;118(12):3191-3192. World Health Organization: Iron deficiency anemia assessment, prevention and control WHO/NHD?01.3 2001. http://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdf Yamani N, Ahmed A, Gosain P, Fatima K, Shaikh AT, Qamar H, Shahid I, Arshad MS, Almas T, Figueredo V.(2021) Effect of iron supplementation in patients with heart failure and iron deficiency: A systematic review and meta-analysis. Int J Cardiol Heart Vasc. 2021 Sep 14;36:100871. doi: 10.1016/j.ijcha.2021.100871. PMID: 34584938; PMCID: PMC8450242. |
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Group specific policy will supersede this policy when applicable. This policy does not apply to the Wal-Mart Associates Group Health Plan participants or to the Tyson Group Health Plan participants.
CPT Codes Copyright © 2024 American Medical Association. |
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