OBJECTIVES: Intravenous (IV) iron is the recommended treatment for patients with iron deficiency anemia (IDA) who are unresponsive to oral iron treatment, or require rapid iron replenishment. Ferric derisomaltose (FDI) and ferric carboxymaltose (FCM) are high-dose, rapid infusion, IV iron formulations that have recently been compared in three head-to-head randomized controlled trials (RCTs), which showed significantly higher incidence of hypophosphatemia after administration of FCM than FDI. The present study objective was to evaluate the cost-utility of FDI versus FCM in a population of Chinese patients with IDA.

METHODS: A previously-published patient-level simulation model was used to model the cost-utility of FDI versus FCM in China. The number of infusions of FDI and FCM was modeled based on the approved posology of the respective formulations using simplified tables of iron need in a population of patients with bodyweight and hemoglobin levels informed by a Chinese RCT of FCM. Data on the incidence of hypophosphatemia was obtained from the PHOSPHARE-IDA RCT, while data on disease-related quality of life was obtained from SF-36v2 data from the PHOSPHARE-IBD RCT. FDI and FCM were assumed to be priced at parity.

RESULTS: Over the five-year time horizon, patients received 3.98 courses of iron treatment on average, requiring 0.90 fewer infusions of FDI than FCM (7.69 versus 6.79). This resulted in iron procurement and administration cost savings of RMB 508 with FDI (RMB 3,927 versus RMB 3,420). Reduced incidence of hypophosphatemia resulted in an increase of 0.073 quality-adjusted life years and further cost savings of RMB 801 over five years, driven by reduced need for phosphate testing and replenishment. FDI was therefore the dominant intervention.

CONCLUSIONS: FDI reduced costs and improved quality-adjusted life expectancy relative to FCM in Chinese patients with IDA, and represents a clinically and economically prudent choice of IV iron in China.