One in 20 Australian women now receiving iron IVs
Flinders University
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Associate Professor Luke Grzeskowiak, College of Medicine and Public Health, Flinders University
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The number of Australian women receiving intravenous iron treatments has surged dramatically over the past decade, with new research revealing that one in 20 women of reproductive age received intravenous iron in 2024.
The new study by researchers at Flinders University, SAHMRI and collaborating institutions found a 17-fold increase in intravenous iron use among women aged 18 to 44 years between 2013 and 2024, with government and patient spending on the medication alone rising from $1.1 million to more than $82 million.
Out-of-pocket costs for women can also be substantial, with some clinics charging hundreds of dollars for an infusion.
Iron deficiency is one of the most common health issues affecting women, particularly during the reproductive years. Heavy menstrual bleeding, pregnancy, childbirth and breastfeeding can all increase the body's demand for iron.
Left untreated, iron deficiency can cause debilitating fatigue, poor concentration, reduced physical capacity and decreased quality of life.
The researchers analysed Pharmaceutical Benefits Scheme (PBS) data from 2013 to 2024 and found intravenous iron use increased from 0.3 women per 100 in 2013 to 5.0 women per 100 in 2024.
The researchers also found almost one in four women did not complete their prescribed treatment course, raising questions about whether some women may be receiving less treatment than intended. Possible explanations include women feeling better after an initial dose or the financial burden associated with additional treatment.
The study found that ferric carboxymaltose, a newer form of intravenous iron, now accounts for almost 94 per cent of all prescriptions. General practitioners were responsible for more than 60 per cent of prescriptions in 2024.
Senior author Associate Professor Luke Grzeskowiak says the findings reflect growing awareness of the impact iron deficiency can have on women’s health.
“For women struggling with iron deficiency, particularly when oral iron tablets are ineffective or cause troublesome side effects, intravenous iron can be an important treatment option,” says Professor Grzeskowiak from Flinders University's College of Medicine and Public Health.
“It can replenish iron stores more quickly and help women feel better sooner, which can make a real difference to their daily lives.”
However, the study also identified substantial differences in overall treatment rate, as well as the type and dose of intravenous iron received, depending on where women lived, their age, concession card status and who prescribed the treatment. In some parts of Australia, rates of use were more than three times higher than others.
Lead author, Dr Gizat Kassie from SAHMRI, says the variation raises important questions about access to treatment and consistency of care.
“We need to better understand what is driving these differences and whether all women are receiving equitable access to the most appropriate treatment,” he says.
“Some of the variation may reflect differences in clinical practice, but cost could also be playing a role. For some women, out-of-pocket expenses can be significant and may influence both access to treatment and whether they complete the recommended course.
“The finding that almost one-quarter of women did not complete their prescribed treatment course is also important. We don't yet know why, but it raises the possibility that some women may not be receiving the full benefit of treatment.”
The researchers note that while intravenous iron is generally safe and effective, it is usually recommended when oral iron has failed, cannot be tolerated, or when rapid replacement of iron stores is needed. Like all medical treatments, it can carry risks and costs that need to be carefully considered.
Professor Grzeskowiak says the findings highlight the need to ensure women receive the right care at the right time.
“Iron deficiency can have a significant impact on women’s health and wellbeing, but it is treatable,” he says.
“Our findings show that intravenous iron has become an increasingly important part of care for Australian women, and we need to make sure its use remains evidence-based, effective and equitable.”
The paper, ‘Increasing utilisation of intravenous iron among Australian women of reproductive age, 2013-2024: an Australian population-based study,’ by Gizat M. Kassie, Hannah Jackson, Lisa Clarke, Kedir Gonete, Jenni Ilomaki, Clare L. Whitehead, Tim Green and Luke E. Grzeskowiak, was published in Internal Medicine Journal. DOI: 10.1111/imj.70494
Associate Professor Luke Grzeskowiak is a practising clinical pharmacist and practitioner Fellow in the College of Medicine and Public Health at Flinders University with expertise in quality use of medicines in pregnancy and lactation.
Acknowledgements: Luke Grzeskowiak receives salary support by a Channel 7 Children's Research Foundation Fellowship (CRF-210323).
Journal
Internal Medicine Journal
Method of Research
Observational study
Subject of Research
People
Article Title
Increasing utilisation of intravenous iron among Australian women of reproductive age, 2013–2024: an Australian population-based study
Feasibility and acceptability of the Cardiac Rehabilitation Especially for Women (CREW) web-based program in rural and remote communities: A mixed-method study
Flinders University
CREW (Cardiac Rehabilitation Especially for Women) is a specific care pathway program developed by the Flinders University-led CHAP Project (Country Heart Attack Prevention) and tested through a study to determine whether the program can be successfully delivered, adopted and accepted by women with cardiovascular disease, and also by cardiac rehabilitation clinicians in rural and remote communities.
“The lack of women-focused programs are major barriers,” says Flinders University researcher Dr Joyce Ramos, “but home-based cardiac rehabilitation using telehealth and gender-tailored approaches may help address these challenges.
The study involved 40 women in rural or remote South Australia who were referred to cardiac rehabilitation through the integrated Cardiovascular Clinical Network (iCCNet) between November 2023 and November 2024. They were invited to use the CREW program, which included four educational modules designed to support self-management, and their completion rates were assessed using digital records.
The participants recorded high rates of cardiac rehabilitation initiation (82.5%) and completion (60%), and the participants also reported high satisfaction with most program components.
“These findings highlighted the value of a women-focused approach to support women engage with their heart health,” says Dr Ramos. “They should also increase clinician awareness about the importance of recognising and addressing women's unique needs throughout the cardiac rehabilitation journey.”
Interviews conducted with the CREW participants and clinicians delivering cardiac rehabilitation explored the CREW program’s feasibility, acceptability and perceived value.
This analysis identified several themes that underlined the CREW program’s strengths: it empowers women in cardiac rehabilitation; it reinforces the value of telehealth-based cardiac rehabilitation for women's participation; and it addresses challenges and resource pressures facing health staff and systems. It also offered recommendations for program enhancement.
“The CREW program is feasible and acceptable to women and clinicians, which shows that this women-focused, web-based model shows promise for addressing gender disparities in cardiac rehabilitation access in rural and remote communities.”
The research – “Feasibility and Acceptability of the Cardiac Rehabilitation Especially for Women (CREW) Web-Based Program in Rural and Remote Communities: A Mixed-Method Study”, by Orathai Suebkinorn, Alline Beleigoli, Robyn Clark, Lemlem Gebremichael, Norma Bulamu, Jeroen Hendriks, Jonathon Foote, Anita Lymn, Sherry Grace and Joyce Ramos, being the Cardiac Rehabilitation Especially for Women (CREW) Project Team – has been published in Heart, Lung and Circulation. DOI: 10.1016/j.hlc.2026.06.021
Method of Research
Observational study
Subject of Research
People
Article Title
Feasibility and Acceptability of the Cardiac Rehabilitation Especially for Women (CREW) Web-Based Program in Rural and Remote Communities: A Mixed-Method Study
Article Publication Date
13-Aug-2026
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