OBJECTIVES. Heart failure with reduced ejection fraction (HFrEF) imposes a significant burden on patients and healthcare systems. Iron deficiency (ID) is common this patient population and places additional burden as ID in patients with HFrEF is associated with poor quality of life and increased risk of hospitalisation and mortality. 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 Italy.

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 from the perspective of healthcare payers in Italy. The eligible patient population was estimated from government HHF data and rates of HHF were sourced from AFFIRM-AHF, a trial of FCM in patients stabilized after an acute heart failure episode and who had HFrEF and ID. Linear regression was used to evaluate the relationship between treatment uptake and events avoided and costs savings accrued. Costs sourced from the published literature.

RESULTS: In total, an estimated 37,155 patients were admitted with HFrEF and ID. Without treatment, these individuals were estimated to incur 42,459 HHF-related bed days with an associated cost of €296.5 million over five years. Treatment with FCM was associated with a reduction in HHF-related bed days of 219 days per 1,000 patients over five years with an associated cost saving of €1.5 million. Treating all 37,155 patients was associated with a reduction in total HHF-related bed days of 8,137 days and a cost saving of €56.8 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 Italian healthcare system.