Casemix-based budget impact analysis of ferric derisomaltose versus ferric carboxymaltose in patients with inflammatory bowel disease and iron deficiency anaemia in the Netherlands

Aims The prevalence of inflammatory bowel disease (IBD) in the Netherlands is approximately 100,000 individuals currently (578 per 100,000 inhabitant), and is rising. Iron deficiency anaemia (IDA) is common in patients with IBD, secondary to chronic blood loss and impaired iron absorption. Intravenous iron is recommended as first-line treatment in patients with clinically active IBD, with previous intolerance to oral iron and in patients who need erythropoietin stimulating agents. The objective was to evaluate the difference in treatment costs and consequential costs of ferric derisomaltose (FDI) versus ferric carboxymaltose (FCM) in patients with IBD and IDA in the Netherlands, based on a casemix model using hospital data from the DBC (Diagnose Behandel Combinatie) system. This study aims to elucidate the differences in budget impact, from a health insurers perspective.Materials and methods In order to model the hospital business, a coding analysis was done, to identify the relevant codes, tariffs, and volumes. In a casemix scenario analysis, the clinical differences between the use of FCM and FDI have been modelled, with a time horizon of 5 years.Results The analysis showed that with FDI the overall costs were lower than with FCM. With full use of FDI in the eligible population, the potential annual savings excluding complications in the national health insurer perspective is €2.9 million (excl. VAT) on iron infusion cost only. Including related costs and complications, the potential annual savings are €28.2 million. The sensitivity analyses proved the outcome to be robust.Limitations Whilst using the DBC data would seem to reflect the real-life clinical behavior, it is known that the DBC system may show some underreporting. The analysis timeframe is limited to 5 years.Conclusions Results showed that FDI significantly reduces healthcare expenditures versus FCM in patients with IBD and IDA in the Netherlands.