Impact of ferric carboxymaltose for iron deficiency at discharge after heart failure hospitalisation: A European multinational economic evaluation

Health Economics and Outcomes Research Ltd, Cardiff, UK. Hospital Lariboisière, AP-HP ; INSERM U948 MASCOT ; Université Paris Cité, Paris, France. Department of Medicine, Karolinska Institutet and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden. Department of Internal Medicine, Malmö University Hospital, Malmö, Sweden. Department of Cardiology and Pneumology, University of Göttingen Medical Center and German Center for Cardiovascular Research (DZHK), partner site Göttingen, Germany. Cardiology Department, Hospital Universitari Bellvitge, University of Barcelona and IDIBELL, Barcelona, Spain. Cardiology Department, Hospital Virgen de la Arrixaca, University of Murcia, Murcia, Spain; and Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. CSL Vifor, Glattbrugg, Switzerland. HEOR, CSL Vifor, Glattbrugg, Switzerland. Institute of Heart Diseases, Wroclaw Medical University, Poland. Institute of Heart Diseases, University Hospital, Wrocław, Poland.

European journal of heart failure. 2023
Abstract
AIMS: Iron deficiency (ID) is comorbid in up to 50% patients with heart failure (HF) and exacerbates disease burden. Ferric carboxymaltose (FCM) reduced HF hospitalisations and improved quality of life when used to treat ID at discharge in patients hospitalised for acute HF with left-ventricular ejection fraction of <50% in the AFFIRM-AHF trial. We quantified the effect of FCM on burden of disease and the wider pharmacoeconomic implications in France, Germany, Poland, Spain and Sweden. METHODS AND RESULTS The per country eligible population was calculated, aligning with the ESC 2021 HF guidelines and the AFFIRM-AHF trial. Changes in burden of disease with FCM versus standard of care (SoC) were represented by disability-adjusted life years (DALYs), hospitalisation episodes and bed days, using AFFIRM-AHF data. A Markov model was adapted to each country to estimate cost-effectiveness and combined with epidemiology data to calculate the impact on healthcare budgets. Between 335 (Sweden) and 13,237 (Germany) DALYs were predicted to be avoided with FCM use annually. Fewer hospitalisations and shorter lengths of stay associated with FCM compared to SoC were projected to result in substantial annual savings in bed days, from 5,215 in Sweden to 205,630 in Germany. In all countries, FCM was predicted to be dominant (cost saving with gains in quality-adjusted life years), resulting in net savings to healthcare budgets within one year. CONCLUSIONS This comprehensive evaluation of FCM therapy highlights the potential benefits that could be realised through implementation of the ESC HF guideline recommendations regarding ID treatment. This article is protected by copyright. All rights reserved.
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Language : eng
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