OBJECTIVES

Iron deficiency anaemia (IDA) is a common complication of inflammatory bowel disease (IBD), and can result in reduced quality of life and increased healthcare costs. IDA is treated with iron supplementation, either with oral iron or with intravenous iron formulations, including ferric carboxymaltose (FCM), iron isomaltoside 1000 (IIM), and iron sucrose (IS). This analysis compared the cost-effectiveness of FCM versus IIM, IS, and oral iron (OI) in terms of additional cost per additional responder in Switzerland.

METHODS

A health-economic model was developed to assess the additional cost per additional responder, defined as normalisation or an increase of ≥2 g/dL in haemoglobin levels, for FCM versus IIM, IS, and OI. To date, no single head-to-head trial comparing all therapies is available, and therefore relative efficacy data were taken from a published network meta-analysis. Costs of treatment were calculated in 2020 Swiss Francs (CHF) using a microcosting approach, and included the costs of iron, healthcare professional time, and consumables. As outcomes were not projected beyond a 1-year time horizon, no discounting was applied to calculated outcomes.

RESULTS

Response rates with FCM, IIM, IS, and OI were 81%, 74%, 75%, and 69%, respectively, with FCM projected to be the most effective treatment. FCM was associated with cost savings of CHF 16 versus IIM and of CHF 157 versus IS, and increased costs by CHF 412 versus oral iron. Therefore, in the intravenous iron category, FCM was found to improve clinical outcomes with cost savings versus both IIM and IS. FCM was associated with an incremental cost-effectiveness ratio of CHF 3,499 per additional responder versus OI.

CONCLUSIONS

FCM was projected to be the most cost-effective IV iron therapy in Switzerland, but healthcare payers must decide whether the additional clinical efficacy of FCM is worth the additional cost when compared with OI.