Objective: An economic evaluation was conducted to investigate the cost-effectiveness of ferric carboxymaltose (FCM) for the treatment of iron deficiency anemia (IDA) in Chinese adult patients.

Methods: A Markov model was built to compare FCM with iron sucrose (IS, Venofer), from a Chinese healthcare perspective over a 6-month period. Three health states were defined, including IDA, responders to treatment, and non-responders to treatment. Patients first entered the model into the IDA state, then transited into either a responders or a non-responders state depending on the efficacy data. The efficacy data was defined as the proportion of patients responding to the treatment (an improvement of 2 g/dL or more in baseline hemoglobin level). Efficacy results were obtained from an open-label phase-III randomized non-inferiority trial, where FCM was compared to IS over a period of 8 weeks (NCT00866047). While direct medical cost was applied in the base-case, including drug, injection and testing costs, the societal perspective was also tested in the sensitivity analysis. Sources of cost data were based on public market prices. Utility data were retrieved from the literature. The impact of uncertainty was evaluated using scenario, deterministic and probabilistic sensitivity analyses.

Results: In the base-case, FCM was more efficacious and less costly over IS, associated with 0.0015 additional QALYs and savings of ¥267 per patient. The main drivers in the model were quick responses and reduced injection frequency of FCM. Scenario and deterministic sensitivity analyses explored the impact of model assumptions and input parameters; FCM, nevertheless , remained dominant over IS. Probabilistic sensitivity analysis indicated that in the range of 1, 2 and 3 times per capita GDP threshold, the probability of FCM being cost-effective is 77%, 83%, and 88%, respectively.

Conclusions: Ferric carboxymaltose is a cost-effective treatment compared to IS for treating iron deficiency anemia in China.