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Titolo Health economic assessment of ferric carboxymaltose in patients with iron deficiency and chronic heart failure based on the FAIR-HF trial: an analysis for the UK
Autore Florian S. Gutzwiller1, Matthias Schwenkglenks1,2, Patricia R. Blank1,2, Peter G. Braunhofer3, Claudio Mori3, Thomas D. Szucs1, Piotr Ponikowski4,5, and Stefan D. Anker6,7 - 1Institute of Pharmaceutical Medicine/ECPM, Universita¨t Basel, CH-4056 Basel, Switzerland; 2Institute of Social and Preventive Medicine, Universita¨t Zu¨rich, Switzerland; 3Vifor Pharma AG, Glattbrugg, Switzerland; 4Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; 5Centre for Heart Diseases, Military Hospital, Wroclaw, Poland; 6Applied Cachexia Research, Department of Cardiology, Charite´ Universita¨tsmedizin Berlin, Germany; and 7Centre for Clinical and Basic Research, IRCCS San Raffaele, Rome, Italy
Referenza European Journal of Heart Failure 2012; 14: 782-790

Aims - The purpose of this study was to evaluate the cost-effectiveness of iron repletion using intravenous (i.v.) ferric carboxymaltose (FCM) in chronic heart failure (CHF) patients with iron deficiency with or without anaemia. Cost-effectiveness was studied from the perspective of the National Health Service in the UK.

Methods and results - A model-based cost-effectiveness analysis was used to compare iron repletion with FCM with no iron treatment. Using data from the FAIR-HF trial and publicly available sources and publications, per patient costs and clinical effectiveness of FCM were estimated compared with placebo. Cost assessment was based on study drug and administration costs, cost of CHF treatment, and hospital length of stay. The incremental cost-effectiveness ratio (ICER) of FCM use was expressed as cost per quality-adjusted life year (QALY) gained, and sensitivity analyses were performed on the base case. The time horizon of the analysis was 24 weeks. Mean QALYs were higher in the FCM arm (difference 0.037 QALYs; bootstrap-based 95% confidence interval 0.017–0.060). The ICER of FCM compared with placebo was E4414 per QALY gained for the FAIR-HF dosing regimen. Sensitivity analyses confirmed the base case result to be robust.

Conclusion - From the UK payers’ perspective, managing iron deficiency in CHF patients using i.v. FCM was cost-effective in this analysis. The base case ICER was clearly below the threshold of E22 200–E33 300/QALY gained (£20 000–£30 000) typically used by the UK National Institute for Health and Clinical Excellence and proved to be robust in sensitivity analysis. Improved symptoms and better quality of life contributed to this result.

Data 14.01.2013
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