OBJECTIVES: Iron deficiency anemia (IDA) is among the most common extraintestinal sequelae of inflammatory bowel disease (IBD). Intravenous iron is the treatment of choice in patients experiencing significant bleeding, iron malabsorption, or intolerance to oral iron. The aim of the present study was to evaluate the cost-utility of ferric derisomaltose (FDI) versus ferric carboyxymaltose (FCM) in patients with IBD and IDA in Norway.

METHODS: A published patient-level simulation model was used to evaluate the cost-utility of FDI versus FCM in patients with IBD and IDA from a Norwegian national payer perspective. Iron need was modeled based on bivariate distributions of hemoglobin and bodyweight combined with simplified tables of iron need from the FDI and FCM summaries of product characteristics. Data on the incidence of post-infusion hypophosphatemia and disease-related quality of life were obtained from the PHOSPHARE-IBD trial. Cost-utility was evaluated in Norwegian Krone (NOK) over a five-year time horizon.

RESULTS: Patients required 1.52 fewer infusions of FDI than FCM over five years (7.20 versus 5.68), corresponding to 0.38 fewer infusions per treatment course. This reduction led to cost savings of NOK 4,506 (NOK 21,342 with FCM versus NOK 16,836 with FDI). Phosphate testing in patients treated with FCM resulted in further cost savings with FDI (NOK 1,735 with FCM versus no costs with FDI). Total cost savings with FDI were therefore NOK 6,241. FDI also increased quality-adjusted life expectancy by 0.075 quality-adjusted life years (QALYs) driven by reduced incidence of hypophosphatemia and fewer interactions with the healthcare system.

CONCLUSIONS: FDI resulted in cost savings and improved quality-adjusted life expectancy versus FCM in patients with IDA and IBD in Norway FDI therefore represents the economically preferable iron formulation in Norwegian patients with IBD and IDA in whom it is indicated.