ESC heart failure · 2026
Cost-effectiveness of intravenous ferric derisomaltose for patients with heart failure and iron deficiency in the UK based on the IRONMAN trial results.
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Pollock R F, Kalra P R, McMurray J J V, Al-Mohammad A, Ahmed F Z, Graham F J, Kalra P A, Pellicori P, Petrie M, Squire I, Ford I, Cleland J G F
Аннотация
BACKGROUND AND AIMS: Iron deficiency is common in patients with chronic heart failure. The IRONMAN trial investigated the effect of intravenous (IV) ferric derisomaltose (FDI) compared to usual care on a composite endpoint of hospitalisations for heart failure and cardiovascular death in patients with either new or established heart failure, iron deficiency, and a left ventricular ejection fraction ≤45%. This analysis explores the health economic consequences of being assigned to FDI rather than usual care from the perspective of NHS England.
METHODS: A cost-utility model of FDI compared to usual care was developed based on individual patient-level data from the IRONMAN trial. The model included quality of life modelled on participant-completed EQ-5D-5L questionnaires, all non-elective hospitalisations and end-of-life care. The analysis was run over a one-year time horizon.
RESULTS: Quality-adjusted life years (QALYs) were numerically greater for FDI (0.563) compared to usual care (0.547), a nominal difference of 0.016 QALYs (95% credible interval [CrI]: 0.002-0.032 QALYs) in favour of FDI. The incremental costs of acquiring and administering FDI were £357, which was more than offset by savings of £936 due to avoided hospitalisations and end-of-life care, resulting in savings of £580 (95% CrI: £493-£678) per patient over one year, 15% less than the cost of usual care.
CONCLUSIONS: Over a one-year time horizon, a within-trial analysis showed that administering FDI to patients with heart failure and iron deficiency was cost saving compared to usual care, driven primarily by reduced rates of hospitalisation.
METHODS: A cost-utility model of FDI compared to usual care was developed based on individual patient-level data from the IRONMAN trial. The model included quality of life modelled on participant-completed EQ-5D-5L questionnaires, all non-elective hospitalisations and end-of-life care. The analysis was run over a one-year time horizon.
RESULTS: Quality-adjusted life years (QALYs) were numerically greater for FDI (0.563) compared to usual care (0.547), a nominal difference of 0.016 QALYs (95% credible interval [CrI]: 0.002-0.032 QALYs) in favour of FDI. The incremental costs of acquiring and administering FDI were £357, which was more than offset by savings of £936 due to avoided hospitalisations and end-of-life care, resulting in savings of £580 (95% CrI: £493-£678) per patient over one year, 15% less than the cost of usual care.
CONCLUSIONS: Over a one-year time horizon, a within-trial analysis showed that administering FDI to patients with heart failure and iron deficiency was cost saving compared to usual care, driven primarily by reduced rates of hospitalisation.