National Public Health Service for Wales, Swansea, UK, Wales.
Objective: To establish whether savings could be made by changing patients from intramuscular to high doses of oral vitamin B12 in primary care without compromising their wellbeing.
Methods: Cost-minimization analysis from a UK perspective, using secondary data obtained from the literature available and expert opinion.
Results: The cost of the resources used to treat patients with vitamin B12 deficiency with intramuscular vitamin B12 was calculated as between pound55.99 (euro83.1) and pound99.99 (euro148.5) per year. The cost of treating patients with high doses of oral vitamin B12 during the first year was between pound125.55 (euro186.5) and pound248.55 (euro369.1). However, once patients receiving intramuscular treatment had been converted to oral treatment, or in new patients treated orally from the outset, the cost was pound35.55 per year (euro52.8). One variable, home visits, had a high impact on the calculations.
Conclusion: Switching patients with vitamin B12 deficiency from intramuscular to high-dose oral therapy and treating patients newly diagnosed with vitamin B12 deficiency with oral vitamin B12 from the outset could save resources in the medium and long term, and in newly diagnosed patients. Savings would come particularly in the form of nursing time.