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Cost-effectiveness analysis of ferric carboxymaltose in iron-deficient patients with chronic heart failure in Sweden.

Hofmarcher, Thomas LU and Borg, Sixten LU (2015) In Journal of Medical Economics 18(7). p.492-501
Abstract
OBJECTIVE:



Iron deficiency is a common but treatable comorbidity in chronic heart failure (CHF) that is associated with impaired health-related quality-of-life (HRQoL). This study evaluates the cost-effectiveness of the intravenous iron preparation ferric carboxymaltose (FCM) for the treatment of iron deficiency in CHF from a Swedish healthcare perspective.



METHODS:



A cost-effectiveness analysis with a time horizon of 24 weeks was performed to compare FCM treatment with placebo. Data on health outcomes and medical resource use were mainly taken from the FAIR-HF trial and combined with Swedish cost data. An incremental cost-effectiveness ratio (ICER) was calculated as well as the... (More)
OBJECTIVE:



Iron deficiency is a common but treatable comorbidity in chronic heart failure (CHF) that is associated with impaired health-related quality-of-life (HRQoL). This study evaluates the cost-effectiveness of the intravenous iron preparation ferric carboxymaltose (FCM) for the treatment of iron deficiency in CHF from a Swedish healthcare perspective.



METHODS:



A cost-effectiveness analysis with a time horizon of 24 weeks was performed to compare FCM treatment with placebo. Data on health outcomes and medical resource use were mainly taken from the FAIR-HF trial and combined with Swedish cost data. An incremental cost-effectiveness ratio (ICER) was calculated as well as the change in per-patient costs for primary care and hospital care.



RESULTS:



In the FCM group compared with placebo, quality-adjusted life years (QALYs) are higher (difference = 0.037 QALYs), but so are per-patient costs [(difference = SEK 2789 (€303)]. Primary care and hospital care equally share the additional costs, but within hospitals there is a major shift of costs from inpatient care to outpatient care. The ICER is SEK 75,389 (€8194) per QALY. The robustness of the result is supported by sensitivity analyses.



CONCLUSIONS:



Treatment of iron deficiency in CHF with FCM compared with placebo is estimated to be cost-effective. The ICER in the base case scenario is twice as high as previously thought, but noticeably below SEK 500,000 (€54,300) per QALY, an informal average reference value used by the Swedish Dental and Pharmaceutical Benefits Agency. Increased HRQoL and fewer hospitalizations are the key drivers of this result. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Medical Economics
volume
18
issue
7
pages
492 - 501
publisher
Informa Healthcare
external identifiers
  • pmid:25766863
  • wos:000361336000002
  • scopus:84942741574
ISSN
1941-837X
DOI
10.3111/13696998.2015.1029491
language
English
LU publication?
yes
id
85b25ab3-8cad-4ead-ab9b-344e11170173 (old id 5261683)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25766863?dopt=Abstract
date added to LUP
2015-04-03 18:21:34
date last changed
2017-08-06 03:28:09
@article{85b25ab3-8cad-4ead-ab9b-344e11170173,
  abstract     = {OBJECTIVE:<br/><br>
<br/><br>
Iron deficiency is a common but treatable comorbidity in chronic heart failure (CHF) that is associated with impaired health-related quality-of-life (HRQoL). This study evaluates the cost-effectiveness of the intravenous iron preparation ferric carboxymaltose (FCM) for the treatment of iron deficiency in CHF from a Swedish healthcare perspective.<br/><br>
<br/><br>
METHODS:<br/><br>
<br/><br>
A cost-effectiveness analysis with a time horizon of 24 weeks was performed to compare FCM treatment with placebo. Data on health outcomes and medical resource use were mainly taken from the FAIR-HF trial and combined with Swedish cost data. An incremental cost-effectiveness ratio (ICER) was calculated as well as the change in per-patient costs for primary care and hospital care.<br/><br>
<br/><br>
RESULTS:<br/><br>
<br/><br>
In the FCM group compared with placebo, quality-adjusted life years (QALYs) are higher (difference = 0.037 QALYs), but so are per-patient costs [(difference = SEK 2789 (€303)]. Primary care and hospital care equally share the additional costs, but within hospitals there is a major shift of costs from inpatient care to outpatient care. The ICER is SEK 75,389 (€8194) per QALY. The robustness of the result is supported by sensitivity analyses.<br/><br>
<br/><br>
CONCLUSIONS:<br/><br>
<br/><br>
Treatment of iron deficiency in CHF with FCM compared with placebo is estimated to be cost-effective. The ICER in the base case scenario is twice as high as previously thought, but noticeably below SEK 500,000 (€54,300) per QALY, an informal average reference value used by the Swedish Dental and Pharmaceutical Benefits Agency. Increased HRQoL and fewer hospitalizations are the key drivers of this result.},
  author       = {Hofmarcher, Thomas and Borg, Sixten},
  issn         = {1941-837X},
  language     = {eng},
  number       = {7},
  pages        = {492--501},
  publisher    = {Informa Healthcare},
  series       = {Journal of Medical Economics},
  title        = {Cost-effectiveness analysis of ferric carboxymaltose in iron-deficient patients with chronic heart failure in Sweden.},
  url          = {http://dx.doi.org/10.3111/13696998.2015.1029491},
  volume       = {18},
  year         = {2015},
}