OBJECTIVES: This study estimates the cost-effectiveness and budget impact of introducing ferric carboxymaltose (FCM) for the treatment of iron deficiency (ID) in patients with left ejection fraction (LVEF) <50%, stabilised after an episode of acute heart failure (AHF), from the perspective of healthcare payers in 5 European countries.

METHODS: A previously published Markov model was used to evaluate the cost-effectiveness in administration of FCM. A budget impact model (BIM) evaluated the costs associated with FCM treatment in an incident AHF hospitalisation population over 5 years. The eligible population for each country was estimated from mean published data and validated by expert opinion. Predictions on market share growth of FCM were validated by clinical expert opinion. Patient-reported (EQ-5D), event outcomes and costs were sourced from published literature and Affirm-AHF clinical trial. Country-specific discount rates were applied.

RESULTS: FCM treatment was estimated to increase quality-adjusted life years (QALYs) (this increase ranged from 0.419 to 0.448 across all countries); driven by a reduction in hospitalisation for HF (HHF) events and an increase in time spent in higher Kansas City Cardiomyopathy Questionnaire (KCCQ) states. Cost offsets associated with lower HHF events resulted in FCM being dominant (more effective and less costly treatment) across all 5 countries; lifetime cost-saving per patient was €80, €173, €488, €554 and € 703 in Spain, Germany, Poland, France and Sweden, respectively.

CONCLUSIONS: FCM for the treatment of ID in patients with LVEF <50%, stabilised after an episode of AHF has the potential to reduce HHF burden and deliver cost savings to healthcare systems, and is estimated to be a highly cost-effective treatment across all 5 countries.