Ferritin thresholds and target ferritin levels are determined at the discretion of the referring clinician, recognizing variability in clinical guidelines, practice patterns, and individual patient factors.

The referring physician, nurse practitioner, or primary care physician remains responsible for arranging appropriate investigations and referrals related to the underlying cause of iron deficiency, including but not limited to malabsorption, gastrointestinal or genitourinary blood loss, menstrual blood loss, chronic kidney disease, and chronic heart failure.

Referrals should include recent laboratory results obtained within the past one to two months, including hemoglobin (Hb), ferritin, and transferrin saturation (TSAT).

IV Iron Infusion

• For patients deemed to require IV iron infusion by the referring physician and/or NP.

• Prescription for IV Iron is not required from the referring doctor and NEO Clinic will handle the

  prescription. This is to avoid any confusion for the patients and to ensure that the medication is stored in

  appropriate temperature during the transportation from the pharmacy to the clinic.

If a patient is referred for IV Iron only, please mention the following details in the referral.

• IV Iron Formulation

• Dose

• Frequency

• Any special instructions

If a patient is referred for neurological symptoms due to Iron deficiency, NEO clinic will provide the prescription and handle any paperwork required.

IV Iron Prescription / Medication Costs

Most IV iron formulations are covered by private drug insurance plans or, for eligible patients, through the Ontario Drug Benefit (ODB) program or the Exceptional Access Program (EAP).

• Monoferric: ~$300 for 500 mg; $600 for 1000 mg (DIN:02477777)

** The cost of IV iron medication may vary depending on the dispensing pharmacy. Patients may also choose to purchase IV iron directly through the infusion clinic and subsequently submit the receipt for reimbursement through their private insurance plan, if eligible.

IV Iron infusion /administration cost is $250 per visit. This fee covers the cost of administering IV iron in the clinic, including nursing time, supplies, patient monitoring during and after the infusion, use of clinic space, and emergency preparedness. Infusion costs are not covered by OHIP in an outpatient community clinic setting and are billed directly to the patient at the time of booking your appointment. An invoice and receipt will be provided for potential reimbursement through private insurance, employer benefits, or for tax purposes. If the infusion cost is a concern,patients are encouraged to discuss this with their healthcare provider, as referral to a regional hospital-based infusion service may be considered where appropriate.

Financial Considerations
If a patient is experiencing financial barriers, we recommend discussing alternative options with the patient and considering referral to a regional hospital-based infusion service where appropriate.

At NEO, IV iron infusions are delivered using formalized clinical protocols and safety procedures consistent with recognized Canadian standards for outpatient medical care.

Standardized Clinical Protocols
NEO maintains written IV iron infusion protocols that define patient assessment, prescribing requirements, dosing, infusion rates, monitoring parameters, and post-infusion observation. Protocols are reviewed regularly and updated in accordance with evolving clinical evidence and safety guidance.

Qualified and Trained Clinical Staff
IV iron is administered by a registered nurse with training in intravenous medication administration and infusion monitoring. Staff are trained to identify early signs of infusion-related reactions and to initiate appropriate clinical responses in a timely manner.

Monitoring and Patient Safety
Patients are monitored before, during, and after the infusion using standardized observation procedures. This includes assessment of vital signs, symptom monitoring, and clear documentation in the medical record, in keeping with professional and regulatory expectations.

Emergency Preparedness
Although serious reactions to IV iron are uncommon, NEO maintains a high level of readiness to manage medical emergencies. The clinic is equipped with:

• Emergency medications appropriate for infusion reactions

• Oxygen delivery and basic airway support equipment

• Emergency response supplies and protocols

• Clearly defined escalation and transfer procedures

All staff are familiar with emergency procedures and participate in regular training to ensure readiness.

Governance, Documentation, and Quality Oversight
IV infusion services at NEO operate within a broader clinical governance framework that emphasizes patient safety, documentation, infection prevention and control, and continuous quality improvement, consistent with Accreditation Canada and CPSO principles for outpatient medical facilities.

Community-Based Care with Hospital-Level Standards
NEO provides IV iron infusions in a professional outpatient environment designed to deliver safe, patient-centred care while meeting the expectations of modern ambulatory medical practice.