Evaluation of cost savings with ferric carboxymaltose in anemia treatment through its impact on erythropoiesis-stimulating agents and blood transfusion: French healthcare payer perspective

Figures & data

Figure 1.  Comparison of treatment strategies in chemotherapy-induced anemia in breast cancer.

Table 1.  Summary of the different direct costs included in the economic modeling (French healthcare payer perspective).

	Cost (€) in 2010
Intravenous ferric carboxymaltose at hospital	Included in chemotherapy cost
ESA at home (for one visit)
ESA for one visit^a	294.84
Nursing	3.15
Total	297.99
ESA + intravenous ferric carboxymaltose at home (for one visit)
ESA^b	221.13
Intravenous ferric carboxymaltose^c	200.00
Nursing	18.90
Total	440.03
Blood transfusion (blood unit plus perfusion)^d	677.37
Blood transfusion for hip/surgery (blood unit only)^e	535.59

^a40,000 IU; based on public hospital price of epoetin beta (€73.71/10,000 U).

^bBased on a decrease of 25% of ESA consumption in combination with intravenous iron24.

^c€20/100 mg; 1000 mg for one injection.

^dMean of public and private costs for one blood transfusion.

^ePerfusion cost included in hospitalization cost.

Table 2.  Estimation of annual cost savings related to intravenous ferric carboxymaltose treatment in different clinical settings (French healthcare payer perspective).

	Metastatic breast cancer	Non-metastatic breast cancer	Digestive cancer	Knee and hip surgery
Number of patients by year	17,535	44,833	44,539	187,375
Estimated number of patients receiving ESA, n (%)	14,028 (80%)	13,450 (30%)	6489 (14.6%)^a	Infrequent
Estimated number of patients receiving blood transfusion, n (%)	7014 (40%)	3587 (8%)	Infrequent	56,213 (30%)
Cost saving for ESA with intravenous ferric carboxymaltose, €^b	16,129,774	15,465,337	7,461,811	NA
Cost saving for blood transfusion with intravenous ferric carboxymaltose, €^c	1,350,526	690,610	NA	12,141,936
Total annual cost saving, €	17,480,300	16,155,947	7,461,811	12,141,936
Annual cost saving per patient, €	997	360	168	216

^aHypotheses: chemotherapy-induced anemia is present in 62% of patients with cancer; 23.5% of patients with cancer are treated with ESA.

^bHypotheses: intravenous ferric carboxymaltose reduces the number of patients receiving ESA by 10% and ESA dosing by 25%.

^cHypotheses: intravenous ferric carboxymaltose reduces the number of blood transfusion by 55% for chemotherapy-induced anemia in breast cancer and 59% for perioperative anemia.

Table 3.  One-way cost-saving sensitivity analyses.

	Parameter estimated
	Value in the initial model	Equilibrium point^a
Breast cancers
Blood transfusion decrease with intravenous ferric carboxymaltose	55%	37%
ESA dosing decrease with intravenous ferric carboxymaltose
Hypothesis 1: 10% decrease of patients receiving ESA	25%	−3%
Hypothesis 2: 0% decrease of patients receiving ESA	25%	9%
Digestive cancers
ESA dosing decrease with intravenous ferric carboxymaltose
Hypothesis 1: 10% decrease of patients receiving ESA	25%	−3%
Hypothesis 2: 0% decrease of patients receiving ESA	25%	9%
Knee/hip surgery
Blood transfusion decrease with intravenous ferric carboxymaltose	59%	18%

^aValue of parameter in the economic model associated with cost saving equals to zero.

Figure 2.  Comparison of treatment strategies in chemotherapy-induced anemia in digestive cancer.

Figure 3.  Comparison of treatment strategies in knee and hip surgery.

Hedenus M, Birgegard G, Nasman P, et al. Addition of intravenous iron to epoetin beta increases hemoglobin response and decreases epoetin dose requirement in anemic patients with lymphoproliferative malignancies: a randomized multicenter study. Leukemia 2007;21:627-32

 PubMed Web of Science ®Google Scholar