OBJECTIVES: Iron deficiency (ID) is common in heart failure (HF) patients and is associated with poor quality of life (QoL) and increased risk of hospitalisation and mortality. The aim of this study was to evaluate the burden of ID in patients with left ventricular ejection fraction (LVEF) <50%, stabilised after an episode of acute heart failure (AHF) and to assess patient and systems outcomes of introducing ferric carboxymaltose (FCM) in five European countries.

METHODS: The estimated eligible population for each country was calculated from published literature and based on the AFFIRM-AHF trial criteria. Disability-adjusted life years (DALYs) was calculated as a composite of years lost of life and years lived with disability. All-cause mortality was estimated by parametric survival analysis and negative binomial estimating equations from an established model generated hospitalisation events within each country. The number of bed-days saved per year in each setting was based on hospital length of stay (derived from AFFIRM-AHF) and hospitalisations averted.

RESULTS: Extrapolation of AFFIRM-AHF data showed that FCM treatment has potential to improve quality adjusted life expectancy in all five countries. In total, estimated number of patients admitted with LVEF <50% and ID were 197,919 in Germany; 71,770 in France; 72,727 in Poland; 5,019 in Sweden; and 44,863 in Spain. Treating all eligible patients was associated with a high number of DALYs being averted and a reduction in hospitalisation for HF and non-HF related hospital bed-days in the first year (DALYs averted and hospital bed-days saved: Germany 15,803 and 205,360; France 6,324 and 74,567; Poland 6,409 and 75,561; Sweden 442 and 5,215; and Spain 4,020 and 47,398).

CONCLUSIONS: Treatment with FCM is associated with a substantial reduction in HF and non-HF hospitalisation and improvement in QoL. This highlights the unmet need for the treatment of ID in this HF patient population in all five countries.