OBJECTIVES: About 40% of maternal and perinatal deaths are linked to anemia, highlighting the importance of actions in health policies aimed at preventing anemia. The objective of this analysis is to calculate the incremental cost-effectiveness ratio (ICER) and budgetary impact (BI) of ferric carboxymaltose (FCM) compared to oral iron in iron deficiency anemia (IDA) in pregnant and postpartum women (PPW) from the Supplementary Health (SS) perspective.

METHODS: In the cost-effectiveness analysis (CEA), two decision tree models were constructed for the two evaluated populations. A BI analysis was performed considering different scenarios of increased utilization rates of FCM for patients with IDA (10%, 40%, 60%, 80% and 80%). The time horizon was projected over 5 years, between 2023 and 2027. Univariate sensitivity analysis (USA) and probabilistic sensitivity analyses (PSA), using second-order Monte Carlo simulation (1000) were also performed.

RESULTS: The use of FCM in the treatment of anemia due to IDA in pregnant women yields an incremental effectiveness of 0.14 QALY with an incremental cost of BRL 760.54. The ICER is BRL 5,432.45/QALY. In the treatment of PPW, it generated an incremental effectiveness of 0.25 QALY with an incremental cost of BRL 1,633.51. The ICER is BRL 6,613.41/QALY. In pregnant women, the incorporation of FCM, in the first year, generates a BI of BRL 24,445,081 and an accumulated impact over 5 years of BRL 658,580,184. For the PPW, it generates a first year BI of BRL 28,235,259 and accumulated impact of BRL 783,294,425.

CONCLUSIONS: Intravenous iron supplementation, particularly FCM, has been shown to be cost effective in relation to the Brazilian willingness to pay of BRL 30,000.00 to BRL 40,000.00/QALY. The BI appears to be predictable and affordable.