COST-UTILITY ANALYSIS OF FERRIC DERISOMALTOSE VERSUS FERRIC CARBOXYMALTOSE FOR THE TREATMENT OF IRON DEFICIENCY ANEMIA IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE IN SLOVENIA
Author(s)
Rok Hren, MSc, PhD1, Tomaž Kocjan, MD, PhD2.
1Syreon Research Institute, Budapest, Hungary, 2Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.
1Syreon Research Institute, Budapest, Hungary, 2Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.
OBJECTIVES: Iron deficiency anemia (IDA) is a common extraintestinal manifestation of inflammatory bowel disease (IBD) and frequently requires intravenous (IV) iron therapy. Ferric derisomaltose (FDI) and ferric carboxymaltose (FCM) are widely used formulations, however, FCM is associated with a substantially higher risk of treatment-emergent hypophosphatemia. Given Slovenia’s low IV infusion tariffs and recent pricing changes favoring FCM acquisition costs, this study evaluated the cost-utility of FDI versus FCM in patients with IBD-associated IDA from the Slovenian healthcare payer perspective.
METHODS: A patient-level microsimulation model was adapted to the Slovenian setting. Clinical inputs were primarily derived from the PHOSPHARE-IBD randomized controlled trial. Differences in hypophosphatemia incidence between treatments were incorporated through health utility estimates derived from the SF-36v2 (36-Item Short Form, version 2) questionnaire. Costs and outcomes were projected over a 10-year time horizon. Deterministic, probabilistic, and scenario-based sensitivity analyses were performed.
RESULTS: FDI required fewer infusions than FCM over 10 years (11.1 vs. 14.2), resulting in limited administration-cost savings because of low Slovenian infusion tariffs. Due to its lower incidence of hypophosphatemia, treatment with FDI generated an incremental gain of 0.136 quality-adjusted life-years (QALYs) compared with FCM. Total costs were €895 higher with FDI, yielding an incremental cost-effectiveness ratio (ICER) of €6,590 per QALY gained, which was below the Slovenian willingness-to-pay threshold of €25,000/QALY. Deterministic, probabilistic and scenario sensitivity analysis demonstrated robustness of results.
CONCLUSIONS: Despite higher acquisition costs and a pricing environment favorable to FCM, FDI was cost-effective versus FCM in Slovenia. The economic value of FDI was primarily driven by its lower risk of IV iron-induced hypophosphatemia and the associated gains in health-related quality of life.
METHODS: A patient-level microsimulation model was adapted to the Slovenian setting. Clinical inputs were primarily derived from the PHOSPHARE-IBD randomized controlled trial. Differences in hypophosphatemia incidence between treatments were incorporated through health utility estimates derived from the SF-36v2 (36-Item Short Form, version 2) questionnaire. Costs and outcomes were projected over a 10-year time horizon. Deterministic, probabilistic, and scenario-based sensitivity analyses were performed.
RESULTS: FDI required fewer infusions than FCM over 10 years (11.1 vs. 14.2), resulting in limited administration-cost savings because of low Slovenian infusion tariffs. Due to its lower incidence of hypophosphatemia, treatment with FDI generated an incremental gain of 0.136 quality-adjusted life-years (QALYs) compared with FCM. Total costs were €895 higher with FDI, yielding an incremental cost-effectiveness ratio (ICER) of €6,590 per QALY gained, which was below the Slovenian willingness-to-pay threshold of €25,000/QALY. Deterministic, probabilistic and scenario sensitivity analysis demonstrated robustness of results.
CONCLUSIONS: Despite higher acquisition costs and a pricing environment favorable to FCM, FDI was cost-effective versus FCM in Slovenia. The economic value of FDI was primarily driven by its lower risk of IV iron-induced hypophosphatemia and the associated gains in health-related quality of life.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE30
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Health Technology Assessment
Disease
Gastrointestinal Disorders, No Additional Disease & Conditions/Specialized Treatment Areas