Introduction Anaemia is a costly complication of IBD and a common trigger of hospitalisation. The FERGImain trial, a multi-centre, randomised, placebo-controlled study, demonstrated that on-demand ferric carboxymaltose (FCM) reduced recurrence of anaemia in non-anaemic IBD patients, which received either FCM or placebo when ferritin-levels fell <100 μg/l. Time to anaemia was assessed within 8 months. We present economic results for this trial and compare costs with those expected for the use of low molecular weight iron dextran (ID) from the perspective of the UK National Health Service.
Methods Patients were analysed when at least one haemoglobin value at baseline and a subsequent value was available (204 randomised and treated (105 FCM, 99 placebo)). Trial-based information on medical resource use was combined with UK prices for drugs, wages and materials. Starting from the single administered dose of FCM (500 mg within 15 min) a comparative cost-analysis was performed against ID (500 mg within 4 h). Incremental costs per avoided anaemia case were calculated.
Results Time to recurrence of anaemia in patients treated for low ferritin was significantly longer in the FCM group (HR 0.62 [95% CI 0.38 to 1.00], Kaplan–Meier analysis; p=0.049, log-rank test). By month 8, anaemia had recurred in 26.7% (FCM) and 39.4% (placebo) of patients. Total costs (including hospitalisation) added up to £499 (±1453, SD) in the FCM arm and £319 for placebo (±1390 SD). The average cost per avoided anaemia case over the study period was £1414. Drug and administration costs for FCM totalled to £231 (£189 and £41, respectively), for a mean cumulative dose of 990 mg iron administered per patient over the study period. Compared to FCM, drug and administration costs for an equal dose of ID would be £517 (£79; £438), respectively.
Conclusion Prevention of anaemia recurrence with FCM is effective and associated with additional costs. However, as treatment costs for single-anaemia episodes are not available, our data on costs per avoided anaemia case is difficult to interpret. In comparison, yearly costs in 2001 for a single anaemic IBD patient have been estimated to £7442 ($10 687). The hypothetical use of ID may save drug costs on the expense of administration costs.
Competing interests F Gutzwiller: Grant/Research Support from: Vifor Pharma Ltd, Switzerland, Conflict with: received a travel grant from Vifor Pharma Ltd, Switzerland, P Blank: Grant/Research Support from: Vifor Pharma Ltd, Switzerland, C Gasche: Conflict with: grant and consultancy honoraria from Vifor International, Pharmacosmos A/S, Fresenius Medical Care, Renapharma Sweden, R Evstatiev: None declared, M Schwenkglenks: Grant/Research Support from: Vifor Pharma Ltd, Switzerland, T D Szucs: Grant/Research Support from: Vifor Pharma Ltd, Switzerland.
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