title: Evaluation of cost savings with ferric carboxymaltose in anemia treatment through its impact on erythropoiesis-stimulating agents and blood transfusion: French healthcare payer perspective.
abstract: OBJECTIVE
  To evaluate the economic impact of intravenous iron (in the form of intravenous iron preparation of ferric carboxymaltose) in three different clinical settings of iron deficiency anemia: chemotherapy-induced anemia in breast cancer, chemotherapy-induced anemia in digestive cancer, and perioperative anemia in knee and hip surgery.
  
  
  METHODS
  The economic model compared the usual therapeutic strategies of anemia without intravenous iron and strategies including intravenous iron, in each of the three clinical settings selected. Costs related to anemia treatment by erythropoiesis-stimulating agents (ESA), blood transfusion, and intravenous iron were estimated and compared inside each setting. Cost savings were calculated from the French healthcare payer perspective. Data included in the economic model were obtained from scientific literature, public health agencies, and medical experts.
  
  
  RESULTS
  The most prominent annual cost savings were observed in chemotherapy-induced anemia in breast cancer (€997 and €360 per patient for metastatic and non-metastatic breast cancers, respectively; global cost saving, €33.6 million). This large impact of intravenous iron on costs was mainly explained by both a lower number of women treated and lower ESA dosing. Mean annual cost saving in digestive cancers and knee and hip surgery were estimated to €168 and €216 per patient and global cost savings of €7.5 and €12.1 million, respectively. Overall, annual cost savings in these three settings were estimated to €53 million including €39 million for ESA cost savings. Sensitivity analysis showed that strategies including intravenous iron remained cost-effective even with wide variations in the assumptions, particularly for cost savings on ESA.
  
  
  CONCLUSIONS
  Economic model based on literature data and expert opinions.
  
  
  CONCLUSIONS
  The present economic model suggests that use of intravenous iron, according to recommendations of international guidelines, is cost saving, particularly in chemotherapy-induced anemia in breast cancers.
authors.affiliation: INSERM, Centre d'Investigations Cliniques-9501, CHU Nancy and Nancy-Université, Vandoeuvre-lès-Nancy, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Luporsi
authors.forename: Lamine
authors.initials: L
authors.lastname: Mahi
authors.forename: Camille
authors.initials: C
authors.lastname: Morre
authors.forename: Jorge
authors.initials: J
authors.lastname: Wernli
authors.forename: Gérard
authors.initials: G
authors.lastname: de Pouvourville
authors.forename: Roland
authors.initials: R
authors.lastname: Bugat
mesh_terms: D000740:Anemia / Q000139:chemically induced / Q000188:drug therapy*; D001803:Blood Transfusion; D017046:Cost Savings / Q000191:economics; D003365:Costs and Cost Analysis; D004305:Dose-Response Relationship, Drug; D004920:Erythropoiesis / Q000187:drug effects*; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D005602:France; D006397:Hematinics / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D008320:Maltose / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D018803:Models, Economic
chemical_list: D005290:Ferric Compounds; D006397:Hematinics; C522335:ferric carboxymaltose; D008320:Maltose