Key result
IV ferric derisomaltose is cost-saving in iron-deficient HF, gaining ~0.02 QALYs and saving £580 per patient.
Why the study?
Iron deficiency is common in chronic heart failure, and the health economic consequences of intravenous ferric derisomaltose compared to usual care were not established.
Does intravenous ferric derisomaltose improve cost-effectiveness compared to usual care in patients with heart failure and iron deficiency in the UK?
Does intravenous ferric derisomaltose improve cost-effectiveness compared to usual care in patients with heart failure and iron deficiency in the UK?
Answers are grounded in this paper and cite their sources.
Intravenous ferric derisomaltose is a cost-saving treatment strategy compared to usual care for patients with heart failure and iron deficiency, primarily driven by reduced hospitalization costs.
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.
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Pollock et al. (2026) studied heart failure and iron deficiency. Intravenous ferric derisomaltose (FDI) vs. usual care was evaluated on Quality-adjusted life years (QALYs) (MD 0.016, 95% CI 0.002-0.032). Administering intravenous ferric derisomaltose for heart failure with iron deficiency was cost-saving, increasing QALYs by 0.016 (95% CrI 0.002-0.032) and saving £580 per patient over 1 year.
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