OBJECTIVES: From the Brazilian private health care perspective, this study compared the cost-effectiveness and budget impact of ferric carboxymaltose (FCM) and placebo for treating iron deficiency (ID) in patients with heart failure (HF), NYHA II and III.

METHODS: A decision tree model was developed to project costs and health outcomes over 52 weeks, based on data from literature. National cost databases, trial data (CONFIRM-HF), treatment costs BRL (Brazilian Reais) and utility inputs. No discount was assigned due to the time horizon. Univariate sensitivity analysis (USA) and probabilistic sensitivity analyses (PSA), using second-order Monte Carlo simulation (1000) were also performed. The budgetary impact (BI) was carried out for 5 years, different market share scenarios and direct costs involved in the current treatment and in the proposed treatment.

RESULTS: Treatment with FCM represents a dominant strategy compared with placebo, leading to national BI savings in five years of BRL 43,945,225. 10% market share in the first year leads to a cost saving of BRL 1,628.866 with an 80% share in the fifth year, the saving would be BRL 13,015.837. The Incremental Cost Effectiveness Ratio (ICER) was dominant BRL 20,517.07 for 1 quality-adjusted life year (QALY). PSA/USA showed the robustness of the model, all simulations reported the cost savings of FCM compared to placebo.

CONCLUSIONS: FCM is a cost-saving option for the treatment of heart failure patients with ID in Brazil.