OBJECTIVES: The AFFIRM-AHF trial established intravenous ferric carboxymaltose (FCM) as safe and effective therapy for reducing the risk of hospitalisations for heart failure (HHF), compared with placebo, in patients stabilized after an acute heart failure episode with reduced ejection fraction (HFrEF) and iron deficiency (ID). The objective of this analysis was to estimate the clinical event and cost consequence of introducing FCM for the treatment of ID in patients with HFrEF to healthcare payers in the UK.

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 in UK. The eligible patient population was estimated based on a published rate of acute HHF in England (78,805), the proportion of HF hospitalisation with a secondary diagnosis of ID (33.7%) and the proportion of these with HFrEF (66.0%). Rates of HHF were sourced from AFFIRM-AHF and costs sourced from the published literature. A linear regression model was used to evaluate the relationship between the uptake of treatment with FCM and clinical events avoided, and costs savings accrued.

RESULTS: An estimated 17,528 patients were admitted with HFrEF and ID. Without treatment, these individuals were estimated to incur 20,051 HHF related bed days with an associated cost of £56.9 million. Treatment with FCM was associated with a reduction of 220 HHF-related bed days per 1,000 patients over 5 years with a corresponding cost savings of £621,983. In a scenario where all patients were treated with FCM, HHF would be reduced by 3,850 bed days with an associated total cost savings of £10.9 million.

CONCLUSIONS: Based on published data there is the potential for FCM to substantially reduce HHF burden and deliver cost savings to the UK healthcare system in patients with acute HFrEF and ID.