OBJECTIVES:

Iron deficiency (ID) appears in 60-80% of patients with inflammatory bowel disease (IBD), out of which about one-third is affected by anemia. Anemia which depicts a frequent extra-intestinal manifestation of IBD has a significant impact on quality-of-life components such as emotional, physical and cognitive functions, the ability to work, hospitalization, as well as healthcare costs. 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 payer’s perspective. IBD patients with IDA run into a Markov-model and receive different iron-deficiency strategies (FCM, Iron-Sucrose (IS), oral or no-treatment) according to current clinical practice. The model includes 6 states (treatment success, recurrent anemia, hospitalization, disease worsening and death) based on RCT-data of FERGIcor and FERGImain. The objective of the model was to assess the influence of a higher percentage of treated patients (65%-74%) in general and an increased share of IV substances (49%-59%) on health-care budgets from the payers perspective. Input-data were derived via a systematic literature review. Direct costs were retrieved from published sources and were expressed in 2016€.

RESULTS:

The result of the BIA shows that an increased use of iron-therapy (+9%) and a shift towards IV application (+10%) in IBD patients with IDA leads to a positive budget impact from the second year onwards (-44.075€ in the 3^rd year). The additionally treated patients (+713) causes increased costs for iron medication and outpatient services (+51,175€ 1^st year to +208,221€ in the 3^rd year). Saving effects are achieved due to reduced hospital stays (-40,679€ in the 1^st year to -252,296€ in the 3^rd year).

CONCLUSIONS:

IV iron therapy with FCM in IDA patients are associated with cost-savings by reduced hospitalisations.