OBJECTIVES To evaluate the cost-effectiveness of iron repletion with ferric carboxymaltorse (FCM), in iron-deficient heart failure (HF) patients in Greece.  METHODS An international  economic model was locally adapted to evaluate the use  ferric carboxymaltorse to standard care over a time horizon of 24 weeks corresponding to the duration of the FAIR-HF trial. The efficacy of therapy was evaluated based on the clinical response to treatment and the number of QALYs per patient accrued during the study. Only direct medical costs (drug acquisition, administration and hospitalization costs) were incorporated in the model, as the analysis was conducted from a third-party payer perspective. With respect to administration cost, two alternative scenarios were considered in the base case analysis: administration in day-case unit and administration in the hospital outpatient department. Probabilistic sensitivity analysis was conducted. Primary outcomes were quality adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICER).  RESULTS In the base case analysis, QALYs of FCM treated patients were higher compared to no iron treated patients by 0.04 QALYs. The total 24-week cost of FCM was higher by €969 and €204, it the two scenarios respectively. This difference was mainly attributed to the administration cost and drug acquisition cost related to FMC. Incremental cost effectiveness analysis showed that treatment with FCM was a cost-effective option resulting in an ICER of €25,506 and €5,368 per QALY gained in the scenarios respectively. Probabilistic sensitivity analysis revealed that FCM was likely to be cost-effective in over 80% and 99% in the two scenarios respectively, at a willingness-to-pay threshold of €34,000 per QALY gained. CONCLUSIONS Ferric carboxymaltose may be a cost – effective option in relation to no iron treatment for the management of iron deficiency of HF patients in Greece.