Health economic assessment of ferric carboxymaltose in patients with iron deficiency and chronic heart failure based on the FAIR-HF trial: an analysis for the UK.
OBJECTIVE
The purpose of this study was to evaluate the cost-effectiveness of iron repletion using intravenous (i.v.) ferric carboxymaltose (FCM) in chronic heart failure (CHF) patients with iron deficiency with or without anaemia. Cost-effectiveness was studied from the perspective of the National Health Service in the UK.


RESULTS
A model-based cost-effectiveness analysis was used to compare iron repletion with FCM with no iron treatment. Using data from the FAIR-HF trial and publicly available sources and publications, per patient costs and clinical effectiveness of FCM were estimated compared with placebo. Cost assessment was based on study drug and administration costs, cost of CHF treatment, and hospital length of stay. The incremental cost-effectiveness ratio (ICER) of FCM use was expressed as cost per quality-adjusted life year (QALY) gained, and sensitivity analyses were performed on the base case. The time horizon of the analysis was 24 weeks. Mean QALYs were higher in the FCM arm (difference 0.037 QALYs; bootstrap-based 95% confidence interval 0.017-0.060). The ICER of FCM compared with placebo was €4414 per QALY gained for the FAIR-HF dosing regimen. Sensitivity analyses confirmed the base case result to be robust.


CONCLUSIONS
From the UK payers' perspective, managing iron deficiency in CHF patients using i.v. FCM was cost-effective in this analysis. The base case ICER was clearly below the threshold of €22 200-€33 300/QALY gained (£20 000-£30 000) typically used by the UK National Institute for Health and Clinical Excellence and proved to be robust in sensitivity analysis. Improved symptoms and better quality of life contributed to this result.
Institute of Pharmaceutical Medicine/ECPM, Universität Basel, CH-4056 Basel, Switzerland. florian.gutzwiller@unibas.ch
Florian S
FS
Gutzwiller
Matthias
M
Schwenkglenks
Patricia R
PR
Blank
Peter G
PG
Braunhofer
Claudio
C
Mori
Thomas D
TD
Szucs
Piotr
P
Ponikowski
Stefan D
SD
Anker
D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D017048:Health Care Costs; D006333:Heart Failure / Q000188:drug therapy / Q000191:economics* / Q000473:pathology; D006801:Humans; D007262:Infusions, Intravenous; D000090463:Iron Deficiencies; D008297:Male; D008320:Maltose / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D018803:Models, Economic; D011336:Probability; D019057:Quality-Adjusted Life Years; D011795:Surveys and Questionnaires; D006113:United Kingdom
D005290:Ferric Compounds; C522335:ferric carboxymaltose; D008320:Maltose