OBJECTIVES: Iron deficiency (ID) is highly prevalent in chronic heart failure (CHF) patients and imposes a significant disease burden for CHF patients with enormous impact on their outcome. CHF with ID is a major reason for hospitalization and represents important costs for the national health care budget in Austria. Yet, only a small percentage of CHF patients with ID are diagnosed. Thus, the objective of this analysis is the evaluation of the cost saving potential through an increased use of intravenous iron therapy with ferric carboxymaltose (FCM) based on clinical trial evidence. METHODS: A budget impact analysis (BIA) with a four-year’s time horizon was developed from the health insurance perspective. The main objective of the model was to assess the change of disease progression due to higher percentage of treated patients with iv iron and subsequently the impact on the health care costs. Disease progression was modelled by using a sequential Markov model with monthly transitions of NYHA health states of the cohort. The model takes into account direct costs (NYHA, hospital, outpatient and iron therapy) from 2014 and data from a systematic literature review (RCT, cohort studies and clinical guidelines). RESULTS: The result of the BIA shows that an increased use of iv iron therapy (based on a iv iron treatment scenario- treated patients +20% and iv iron treated patients +10%) in Austria would lead to a positive budget impact. By treating ID with FCM saving effects are achieved through reduced cost in the CHF management (NYHA class shift) and reduced hospitalizations. The overall saving effect was calculated as €225,115 in 2014 to €684,443 in the 3^rd year. CONCLUSIONS: Iv iron therapy with FCM in iron deficient CHF patients can be associated with substantial cost savings based on reduced hospitalisations and improved CHF functional class (NYHA).