title: Cost-utility of ferric carboxymaltose (Ferinject®) for iron-deficiency anemia patients with chronic heart failure in South Korea.
abstract: BACKGROUND
  Iron-deficiency anemia (IDA) is prevalent in patients with advanced chronic heart failure (CHF). It affects the patients' overall physical condition and is suggested as a strong outcome predictor in CHF. Recent clinical trials suggested that intravenous iron supplementation improves CHF functional status and quality of life. The aim of this study was to assess the cost-effectiveness of ferric carboxymaltose(FCM) in CHF patients with IDA.
  
  
  METHODS
  Ferric carboxymaltose, an intravenous iron preparation, was compared with placebo. The target population comprised CHF patients with IDA in hospital and outpatient care settings. We conducted this study from the Korean healthcare payers' perspective with a time horizon of 24 weeks. One clinical trial provided the clinical outcomes of ferric carboxymaltose therapy. The improvement rates of the New York Heart Association (NYHA) functional class in the placebo and ferric carboxymaltose groups were used to estimate effectiveness in the base-case model. We also conducted a scenario 2 analysis using quality of life investigated in the clinical trial. A panel survey was conducted to obtain the ratio of healthcare resource use based on NYHA class in Korea. Cost-effectiveness was expressed as incremental cost (US dollars) per quality-adjusted life-year (QALY) gained.
  
  
  RESULTS
  In the base-case analysis, the incremental cost-effectiveness ratio (ICER) of ferric carboxymaltose compared with placebo was $22,192 (₩25,010,451) per QALY gained. The sensitivity analysis showed robust results, with the ICERs of ferric carboxymaltose ranging from $5,156 to $29,796 per QALY gained. In the scenario 2 analysis, ICER decreased to $12,598 (₩14,198,501) per QALY gained.
  
  
  CONCLUSIONS
  Iron repletion with ferric carboxymaltose for IDA in CHF patients was cost-effective compared with placebo.
authors.affiliation: College of Pharmacy, Korea University Sejong Campus 2511 Sejong-ro, Sejong City 339-770, Korea.
authors.forename: Eun-A
authors.initials: EA
authors.lastname: Lim
authors.affiliation: College of Pharmacy, Ajou University, 206 Worldcup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do 443-749, Korea.
authors.forename: Hyun-Soon
authors.initials: HS
authors.lastname: Sohn
authors.affiliation: College of Pharmacy, Korea University Sejong Campus 2511 Sejong-ro, Sejong City 339-770, Korea.
authors.forename: Haeyoung
authors.initials: H
authors.lastname: Lee
authors.affiliation: College of Pharmacy, Korea University Sejong Campus 2511 Sejong-ro, Sejong City 339-770, Korea.
authors.forename: Sang-Eun
authors.initials: SE
authors.lastname: Choi
keywords: Chronic heart failure; Cost utility; Cost-effectiveness; Iron-deficiency anemia; New York heart association (NYHA) functional class