A Cost-Utility Analysis of Ferric Derisomaltose vs. Ferric Carboxymaltose in Patients with Iron Deficiency Anemia and Inflammatory Bowel Disease in the United Kingdom: Accounting for Difference in Fracture Risk
Author(s)
Marlene Panzer, MD1, Llywelyn Cadman-Davies, MBBS2, Nicholas A Kennedy, MBBS3, Stefan Lindgren, MD4, Johannes Pöhlmann, BA, MPH, MSc5, Richard F. Pollock, MA, MSc5.
1Medical University of Innsbruck, Innsbruck, Austria, 2Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom, 3Royal Devon University Healthcare NHS Foundation Trust, Exeter, United Kingdom, 4Lund University, Lund, Sweden, 5Covalence Research Ltd, Harpenden, United Kingdom.
1Medical University of Innsbruck, Innsbruck, Austria, 2Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom, 3Royal Devon University Healthcare NHS Foundation Trust, Exeter, United Kingdom, 4Lund University, Lund, Sweden, 5Covalence Research Ltd, Harpenden, United Kingdom.
OBJECTIVES: Iron deficiency anaemia (IDA) is a common comorbidity in inflammatory bowel disease (IBD) that can impair quality of life (QoL). Iron deficiency and IDA can be treated with intravenous (IV) iron, but modern formulations such as ferric derisomaltose (FDI) and ferric carboxymaltose (FCM) differ in safety profiles. While both are effective in correcting iron deficiency, emerging data suggest important differences in treatment-related adverse events. This study extended a prior cost-utility analysis comparing FDI with FCM by incorporating, for the first time, country-specific fracture risks.
METHODS: Data on fracture incidence were available from a tertiary referral centre in Austria, on 289 patients treated with FDI (n=110) or FCM (n=179). The study showed no change in fracture risk before and after treatment with FDI. Fracture rates in the FDI arm were based on age- and sex-matched UK general population fracture rates, with FCM rates derived using a relative rate from the Austrian study (RR=1.94 versus FDI). Costs were derived from publicly-available UK-specific sources using 2023 pounds sterling. Fracture management was assumed to cost £6,255 per event. Health-related quality of life was modelled using published utilities for IBD and treatment-related sequelae. A UK national payer perspective and 5-year time horizon were adopted, with costs and outcomes discounted at 3.5% annually.
RESULTS: FDI was associated with 2.66 quality-adjusted life years (QALYs), versus 2.58 QALYs with FCM. Per-patient costs were £2,744 with FDI and £4,190 with FCM resulting in total savings of GBP 1,446 including GBP 597 on iron and iron administration. FCM-related costs for phosphate monitoring and replenishment (GBP 221) and fracture risk (GBP 628) accounted for the remaining savings. Fractures drove 10.9% of the QALY difference (0.01 QALYs).
CONCLUSIONS: Incorporating treatment-specific fracture risks in a cost-utility analysis comparing FDI and FCM showed that FDI was the dominant treatment option for IDA in patients with IBD.
METHODS: Data on fracture incidence were available from a tertiary referral centre in Austria, on 289 patients treated with FDI (n=110) or FCM (n=179). The study showed no change in fracture risk before and after treatment with FDI. Fracture rates in the FDI arm were based on age- and sex-matched UK general population fracture rates, with FCM rates derived using a relative rate from the Austrian study (RR=1.94 versus FDI). Costs were derived from publicly-available UK-specific sources using 2023 pounds sterling. Fracture management was assumed to cost £6,255 per event. Health-related quality of life was modelled using published utilities for IBD and treatment-related sequelae. A UK national payer perspective and 5-year time horizon were adopted, with costs and outcomes discounted at 3.5% annually.
RESULTS: FDI was associated with 2.66 quality-adjusted life years (QALYs), versus 2.58 QALYs with FCM. Per-patient costs were £2,744 with FDI and £4,190 with FCM resulting in total savings of GBP 1,446 including GBP 597 on iron and iron administration. FCM-related costs for phosphate monitoring and replenishment (GBP 221) and fracture risk (GBP 628) accounted for the remaining savings. Fractures drove 10.9% of the QALY difference (0.01 QALYs).
CONCLUSIONS: Incorporating treatment-specific fracture risks in a cost-utility analysis comparing FDI and FCM showed that FDI was the dominant treatment option for IDA in patients with IBD.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE16
Topic
Economic Evaluation, Methodological & Statistical Research, Study Approaches
Disease
Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)