OBJECTIVES:

A widespread complication of inflammatory bowel disease (IBD) is iron deficiency anaemia (IDA), which affects quality of life (QoL) and is associated with frequent hospitalizations. The intravenous iron therapies, ferric carboxymaltose (FCM), ferric derisomaltose (FD) and iron sucrose (IS), have previously been shown to replenish haemoglobin (Hb)-levels more effectively than oral iron. However, they differ in both costs and efficacy (response to treatment), leading to differences in acquisition by healthcare payers. This study investigated the cost-effectiveness of FCM versus FD and IS, in terms of additional cost per additional responder, for the treatment of IBD-associated IDA in multiple Swedish regional settings, using current tender prices.

METHODS:

A microsimulation model estimated the additional cost per additional responder, based on Hb-normalization or an increase of ≥2 g/dL in Hb-levels. Efficacy estimates were taken from a previously published network meta-analysis. Treatment costs (estimated in 2021 SEK) included current tender prices for Swedish healthcare regions. Resource use depended partly on dosing, which was based on varying patient characteristics simulated in the model. Scenario and deterministic sensitivity analyses were performed. Lack of QoL data barred the possibility of a cost utility analysis.

RESULTS:

For all included regions, the analysis showed that FCM was associated with the highest number of responders (81%) compared to FD (74%) and IS (75%). Moreover, the results show that FCM was less costly compared to both FD and IS. Although the iron dose and number of infusions were slightly higher for FCM compared to FD, the difference in infusion times made the cost of treatment cheaper.

CONCLUSIONS:

These results suggest that regional healthcare budget holders should consider more than drug prices when choosing which IV formulations to procure. This analysis provides regional decision makers with additional tools to tailor their resource allocation to fit the needs of their patients.