Cost-utility of ferric carboxymaltose (Ferinject (R)) for iron-deficiency anemia patients with chronic heart failure in South Korea

초록

Background: Iron-deficiency anemia (IDA) is prevalent in patients with advanced chronic heart failure (CHF). It affects the patients' overall physical condition and is suggested as a strong outcome predictor in CHF. Recent clinical trials suggested that intravenous iron supplementation improves CHF functional status and quality of life. The aim of this study was to assess the cost-effectiveness of ferric carboxymaltose(FCM) in CHF patients with IDA. Methods: Ferric carboxymaltose, an intravenous iron preparation, was compared with placebo. The target population comprised CHF patients with IDA in hospital and outpatient care settings. We conducted this study from the Korean healthcare payers' perspective with a time horizon of 24 weeks. One clinical trial provided the clinical outcomes of ferric carboxymaltose therapy. The improvement rates of the New York Heart Association (NYHA) functional class in the placebo and ferric carboxymaltose groups were used to estimate effectiveness in the base-case model. We also conducted a scenario 2 analysis using quality of life investigated in the clinical trial. A panel survey was conducted to obtain the ratio of healthcare resource use based on NYHA class in Korea. Cost-effectiveness was expressed as incremental cost (US dollars) per quality-adjusted life-year (QALY) gained. Results: In the base-case analysis, the incremental cost-effectiveness ratio (ICER) of ferric carboxymaltose compared with placebo was $22,192(.25,010,451)perQALYgained.Thesensitivityanalysisshowedrobustresults,withtheICERsofferriccarboxymaltoserangingfrom$5,156 to $29,796perQALYgained.Inthescenario2analysis,ICERdecreasedto$12,598 (W14,198,501) per QALY gained. Conclusions: Iron repletion with ferric carboxymaltose for IDA in CHF patients was cost-effective compared with placebo.

키워드