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

McEwan, Phil ; Harrison, Cale ; Binnie, Rhona ; Lewis, Ruth D. ; Cohen-Solal, Alain ; Lund, Lars H. ; Ohlsson, Marcus LU orcid ; von Haehling, Stephan ; Comin-Colet, Josep and Pascual-Figal, Domingo A. , et al. (2023) In European Journal of Heart Failure 25(3). p.389-398
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 hospitalizations and improved quality of life when used to treat ID at discharge in patients hospitalized for acute HF with left ventricular ejection fraction <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 2021 European Society of Cardiology (ESC) HF guidelines and the AFFIRM-AHF trial. Changes in burden of disease with FCM versus standard of care (SoC) were... (More)

Aims: Iron deficiency (ID) is comorbid in up to 50% patients with heart failure (HF) and exacerbates disease burden. Ferric carboxymaltose (FCM) reduced HF hospitalizations and improved quality of life when used to treat ID at discharge in patients hospitalized for acute HF with left ventricular ejection fraction <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 2021 European Society of Cardiology (ESC) 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), hospitalization 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 hospitalizations and shorter lengths of stay associated with FCM compared to SoC were projected to result in substantial annual savings in bed days, from 5215 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 1 year. Conclusions: This comprehensive evaluation of FCM therapy highlights the potential benefits that could be realized through implementation of the ESC HF guideline recommendations regarding ID treatment.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Budget impact, Burden of disease, Cost-effectiveness, Ferric carboxymaltose, Heart failure, Iron deficiency
in
European Journal of Heart Failure
volume
25
issue
3
pages
10 pages
publisher
Elsevier
external identifiers
  • pmid:36718652
  • scopus:85150424691
ISSN
1388-9842
DOI
10.1002/ejhf.2788
language
English
LU publication?
no
additional info
Publisher Copyright: © 2023 CSL Vifor. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
id
735b741b-ae2f-4af2-9142-23f23a8340d7
date added to LUP
2024-01-12 15:37:56
date last changed
2024-04-13 09:03:52
@article{735b741b-ae2f-4af2-9142-23f23a8340d7,
  abstract     = {{<p>Aims: Iron deficiency (ID) is comorbid in up to 50% patients with heart failure (HF) and exacerbates disease burden. Ferric carboxymaltose (FCM) reduced HF hospitalizations and improved quality of life when used to treat ID at discharge in patients hospitalized for acute HF with left ventricular ejection fraction &lt;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 2021 European Society of Cardiology (ESC) 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), hospitalization 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 hospitalizations and shorter lengths of stay associated with FCM compared to SoC were projected to result in substantial annual savings in bed days, from 5215 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 1 year. Conclusions: This comprehensive evaluation of FCM therapy highlights the potential benefits that could be realized through implementation of the ESC HF guideline recommendations regarding ID treatment.</p>}},
  author       = {{McEwan, Phil and Harrison, Cale and Binnie, Rhona and Lewis, Ruth D. and Cohen-Solal, Alain and Lund, Lars H. and Ohlsson, Marcus and von Haehling, Stephan and Comin-Colet, Josep and Pascual-Figal, Domingo A. and Wächter, Sandra and Dorigotti, Fabio and de Arellano, Antonio Ramirez and Ponikowski, Piotr and Jankowska, Ewa A.}},
  issn         = {{1388-9842}},
  keywords     = {{Budget impact; Burden of disease; Cost-effectiveness; Ferric carboxymaltose; Heart failure; Iron deficiency}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{389--398}},
  publisher    = {{Elsevier}},
  series       = {{European Journal of Heart Failure}},
  title        = {{Impact of ferric carboxymaltose for iron deficiency at discharge after heart failure hospitalization : a European multinational economic evaluation}},
  url          = {{http://dx.doi.org/10.1002/ejhf.2788}},
  doi          = {{10.1002/ejhf.2788}},
  volume       = {{25}},
  year         = {{2023}},
}