OBJECTIVES: Iron deficiency (ID) is common in patients with heart failure with reduced ejection fraction (HFrEF) and is associated with poor quality of life and increased risk of hospitalisation and mortality, which impose a significant burden on patients and healthcare systems. The objective of this analysis was to estimate the cost consequence of introducing FCM for the treatment of ID in patients with HFrEF from the perspective of healthcare payers in Switzerland.

METHODS: A de novo cost-offset model was built to estimate the impact of introducing FCM for the treatment of ID in HFrEF patients over a five-year time horizon. The eligible patient population was estimated from mean published HHF data for 2012-2015 in Switzerland, to which assumed proportions of secondary diagnosis of ID (33.7%) and HFrEF (66.0%) were taken from other settings. Linear regression was used to evaluate the relationship between treatment uptake and events avoided and costs savings accrued. Rates of HHF were sourced from AFFIRM-AHF, a trial of FCM in patients who had acute HFrEF and ID. Costs sourced from the published literature.

RESULTS: In total, an estimated 4,879 patients were admitted with HFrEF and ID. Without treatment, these individuals were estimated to incur 5,583 HHF-related bed days with an associated cost of CHF76.2 million over five years. Treatment with FCM was associated a reduction in HHF-related bed days of 220 days per 1,000 patients over five years with an associated cost saving of CHF3.0 million. Treating all 4,879 patients was associated with a reduction in total HHF-related bed days of 1,073 days and a cost saving of CHF14.6 million.

CONCLUSIONS: Based on the results of AFFIRM-AHF, FCM for the treatment of ID in patients with HFrEF has the potential to reduce HHF burden and deliver cost savings to the healthcare system in Switzerland.