OBJECTIVES: Intravenous (IV) irons are second line treatments for iron deficiencies in severe chronic kidney disease (CKD) patients with iron deficiency anaemia. Aim of this study was to compare ferumoxytol, a new agent, against IV ferric carboxymaltose (FC) and IV iron sucrose (IS), from a Belgian health care payer (BP) and hospital perspective (HP). METHODS: The CKD patients were categorized in haemodialysis (HD), peritoneal dialysis (PD), non-dialysis (post-renal transplant and non-dialysis) and all patients combined. The available IV irons have a similar efficacy. Adverse events were not included due to missing comparative data and low rates. However, the administration time and number of administrations differ among treatments. So a cost-minimization analysis was conducted (time horizon: 1 year). The average annual need of IV Iron is 3,500 mg in HD, 2,500 mg in PD and 1,500 mg in non-dialysis patients. The hospital perspective was modelled by deducting the nurse time cost from the hospital fee per administration (HP). For the health care payer the administration cost (hospital fee) and the drug costs are included (BP). Other costs were excluded because they did not affect the incremental cost of treatment. RESULTS: The total cost (euro 2012) for all patients was € 676.57, € 819.82 and € 617.34 for ferumoxytol, FC and IS, respectively (BP). In the renal transplant and non-dialysis subgroups, ferumoxytol is less costly than FC and IS (BP). In the HD subgroup (86.77% of all eligible patients), IS is the least costly option (BP). The hospital cost in all patients is higher with IS due to more nurse time (€ 101.31, € 7.58 and € 144.19 for ferumoxytol, FC and IS) (HP). CONCLUSIONS: Hospitals benefit from lower administration costs with ferumoxytol and FC (HP). From a Belgian payer perspective, ferumoxytol is less costly than FC and more costly than IS.