A Cost-effectiveness Analysis of Ferric Carboxymaltose in Patients with Heart Failure and Iron Deficiency: A Systematic Review
Ratih Puspita Febrinasari (1), Qonita Fatikhia Syafira (2), Namira Putri Imani (2), Mega Astriningrum (2), Yusuf Ari Mashuri (2*)

1. Department of Pharmacology, Faculty of Medicine, Universitas Sebelas Maret, Indonesia
2. Faculty of Medicine, Universitas Sebelas Maret, Indonesia
* yusufmashuri[at]staff.uns.ac.id

Abstract

Introduction: Iron deficiency is one of the heart failure comorbidities. As therapy of choice, ferric carboxymaltose can improve clinical symptoms and increase the quality of life in heart failure patients with iron deficiency. This study aims to evaluate and conclude the cost-effectiveness of ferric carboxymaltose in heart failure patients with iron deficiency.
Methods: This was a systematic review of all articles collected from databases such as Pubmed, Scopus, Web of Science, EBSCO, ProQuest, Science Direct, and Global Health Databases which were published from 2012 to 2022. The population in this study were HFrEF patients with iron deficiency older than 18 years old who were treated with ferric carboxymaltose. A descriptive narrative approach using the CHEERS checklist was used to analyze the data.
Results: Seven studies from 679 articles were included in the analysis. One article used the Markov model study design, five articles with model-based study, and one article used a cost-utility approach. Two articles used the payer^s perspective, an article about the healthcare provider^s perspective, and four articles used the healthcare national system^s perspective. Five articles have very good quality (70-85%), and two articles have high quality (>85%). From ten countries (Spain, UK, Sweden, Denmark, Finland, Norway, South Korea, Italy, USA, and Switzerland), South Korea has the highest ICERs at -18.254/QALY, with an incremental cost of -466, and the outcomes 0.021 QALY.
Conclusions: Ferric carbooxymaltose is cost-effective for heart failure with iron deficiency treatment, which has an average ICER value of -7,814/QALY and a middle value of -6,678/QALY.

Keywords: cost-effectiveness, ferric carboxymaltose, heart failure, iron deficiency, pharmacoeconomic

Topic: Medical : basic science, clinical, translational research, medical education, and miscellaneous