A Cost-effectiveness Analysis of Ferric Carboxymaltose in Patients With Iron Deficiency and Chronic Heart Failure in Spain

Comín‐Colet, Josep; Rubio-Rodríguez, Darío; Rubio-Terrés, Carlos; Enjuanes-Grau, Cristina; Gutzwiller, F; Anker, Stefan D.; Ponikowski, Piotr

doi:10.1016/j.rec.2014.10.010

Cited by 23 publications

(22 citation statements)

References 19 publications

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“…Their analysis only modelled the time horizon of 24 weeks but showed similar conclusions. Comin‐Colet et al 27 came to the same results in their cost‐effectiveness analysis in Spain. They used the data of the FAIR‐HF trial and took only the time horizon of 24 weeks.…”

Section: Discussionmentioning

confidence: 67%

Budget impact of intravenous iron therapy with ferric carboxymaltose in patients with chronic heart failure and iron deficiency in Germany

Theidel¹,

Väätäinen

Martikainen

et al. 2017

ESC Heart Failure

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AimsTreatment of iron deficiency (ID) in patients with heart failure (HF) with intravenous iron substitution [ferric carboxymaltose (FCM)] has previously shown significant improvements in exercise capacity, New York Heart Association (NYHA) functional class, quality of life, and reduction of hospitalization. The aim of this study was to estimate the budget impact of FCM treatment for patients with HF and ID.Methods and resultsIndividual patient data from four double‐blind randomized controlled trials were pooled for this analysis. Expected outcomes were modelled for a treatment period of 1 year, using multivariate statistical methods. Associated unit costs were derived from claims data. Budget impact was calculated from the perspective of the Statutory Health Insurance. Multiple deterministic sensitivity analyses were performed. The annual budget impact for therapy with FCM vs. no‐iron therapy was €2 735 505 and €2 695 474 for 1000 patients, respectively, resulting in additional annual costs of €40.03 for each treated patient. Main costs drivers are the FCM treatment cost and cost of hospitalizations due to HF worsening. FCM therapy compared with no‐iron therapy resulted in reduced cost per 1000 patients: for reduced hospitalization due to HF worsening (52 vs. 129 hospitalizations amounting to €230 591 vs. €597 078), for reduced other medication (€1 611 007 vs. €1 679 908), fewer outpatient visits (€332 523 vs. €378 019), and home visits (€29 627 vs. €40 469). Sensitivity analyses showed robustness of the results.ConclusionsTherapy with FCM has a minimal budget impact of €40 031 per 1000 patients per year. This budget impact translates into reduced and shorter hospitalizations and improved symptomatic status of the patients.

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Section: Discussionmentioning

confidence: 67%

Budget impact of intravenous iron therapy with ferric carboxymaltose in patients with chronic heart failure and iron deficiency in Germany

Theidel¹,

Väätäinen

Martikainen

et al. 2017

ESC Heart Failure

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“…FCM is of practical interest because of resource availability and logistical challenges being barriers to widespread adoption of i.v. administration despite multiple studies demonstrating its cost‐effectiveness 28, 29, 30, 31. While early trials of oral iron supplementation were negative, they comprised small sample sizes, involved single centres, were not the primary focus of investigation, and were often paired with erythropoiesis‐stimulating agents 32, 33.…”

Section: Discussionmentioning

confidence: 99%

“…administration despite multiple studies demonstrating its cost-effectiveness. [28][29][30][31] While early trials of oral iron supplementation were negative, they comprised small sample sizes, involved single centres, were not the primary focus of investigation, and were often paired with erythropoiesis-stimulating agents. 32,33 A multicentre randomized controlled trial has just been completed, investigating the effects of oral iron polysaccharide vs. oral placebo in improving functional capacity (measured by maximum oxygen uptake during cardiopulmonary exercise testing) in patients with HFrEF and ID (the IRONOUT-HF trial).…”

Section: New Developmentsmentioning

confidence: 99%

Single‐dose intravenous iron in Southeast Asian heart failure patients: A pilot randomized placebo‐controlled study (PRACTICE‐ASIA‐HF)

Yeo

Hadi³

et al. 2018

ESC Heart Failure

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AimsIron deficiency is highly prevalent in Southeast Asians with heart failure (HF) and associated with worse outcomes. This trial aimed to assess the effect of intravenous iron in Southeast Asians hospitalized with decompensated HF.Methods and resultsFifty patients hospitalized for acute decompensated HF, regardless of ejection fraction, with iron deficiency (defined as serum ferritin <300 ng/mL if transferrin saturation is <20%) were randomized to receive either one dose of intravenous ferric carboxymaltose (FCM) 1000 mg or placebo (0.9% saline) following HF stabilization and before discharge in two Singapore tertiary centres. The primary endpoint was difference in 6‐min walk test (6MWT) distance over 12 weeks, while secondary endpoints were quality of life assessed using validated Kansas City Cardiomyopathy Questionnaire (KCCQ) and Visual Analogue Scale (VAS). Improvement in 6MWT distance at Week 12 was observed in both FCM and placebo groups (from 252 ± 123 to 334 ± 128 m and from 243 ± 67 to 301 ± 83 m, respectively). Unadjusted analysis showed 6MWT distance for FCM exceeded that for placebo, but adjustment for baseline covariates and time attenuated this effect {adjusted mean difference between groups: 0.88 m [95% confidence interval (CI) −30.2 to 32.0, P = 0.956]}. KCCQ overall summary and VAS were similar in both groups [adjusted mean difference: KCCQ −1.48 (95% CI −8.27 to 5.31, P = 0.670) and VAS 0.26 (95% CI −0.33 to 0.86, P = 0.386)]. FCM was well tolerated with no serious treatment‐related adverse events.ConclusionsIntravenous FCM administered pre‐discharge in Southeast Asians hospitalized with decompensated HF is clinically feasible. Changes in 6MWT distance should be measured beyond Week 12 to account for background therapy effects.

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“…Cost effectiveness of treatment with intravenous iron in patients with CHF and iron deficiency has been evaluated in several studies using data from the FAIR‐HF trial and modeling it according several European health systems. In these models, the use of FCM for the treatment of ID in patients with CHF was cost‐effective since the incremental cost‐effectiveness ratio of FCM use was below the threshold of cost per QALY gained suggested by the UK National Institute for Health and Clinical Excellence . Overall, the evidence for the relative merits of oral versus intravenous iron, has been evolving, and now suggests that prompt intervention using IV iron therapy should now be considered .…”

Section: Iron Therapymentioning

confidence: 99%

Management of anemia in patients with congestive heart failure

Goodnough

Comín‐Colet

Leal-Noval³

et al. 2016

American J Hematol

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Anemia is an independent risk factor for adverse patient outcomes. There are no guidelines for management of anemia in patients with congestive heart failure (CHF), despite its high incidence. Four objectives were defined by the International Anemia Management and Clinical Outcomes Expert Panel (AMCO), a multinational group of interdisciplinary experts identified by the Society for the Advancement of Blood Management (SABM) to: determine the prevalence of anemia in outpatients; to determine the prevalence of hospital‐acquired anemia; to assess the impact of anemia management on clinical outcomes such as quality of life and functional status; and to provide recommendations for primary care physicians and specialists for the diagnosis, evaluation, and management of anemia in patients with CHF. Anemia and iron deficiency were confirmed to be highly prevalent in patients with CHF. Intravenous iron therapy improves anemia, cardiac function and exercise tolerance, leading to improvement in quality of life. Anemia management has been demonstrated to be cost‐effective. Clinical care pathways to manage anemia in patients with CHF are recommended as best practices in order to improve patient outcomes. Am. J. Hematol. 92:88–93, 2017. © 2016 Wiley Periodicals, Inc.

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A Cost-effectiveness Analysis of Ferric Carboxymaltose in Patients With Iron Deficiency and Chronic Heart Failure in Spain

Cited by 23 publications

References 19 publications

Budget impact of intravenous iron therapy with ferric carboxymaltose in patients with chronic heart failure and iron deficiency in Germany

Budget impact of intravenous iron therapy with ferric carboxymaltose in patients with chronic heart failure and iron deficiency in Germany

Single‐dose intravenous iron in Southeast Asian heart failure patients: A pilot randomized placebo‐controlled study (PRACTICE‐ASIA‐HF)

Management of anemia in patients with congestive heart failure

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