Casemix-based budget impact analysis of ferric derisomaltose versus ferric carboxymaltose in patients with inflammatory bowel disease and iron deficiency anaemia in the Netherlands.
Ferric derisomaltose could lead to substantial cost savings compared to ferric carboxymaltose in treating iron deficiency anemia in patients with inflammatory bowel disease.
Where it sits
this study against the rest of the erythropoietin (epo) corpusSummary and findings
This study evaluated the cost differences between ferric derisomaltose (FDI) and ferric carboxymaltose (FCM) in patients with inflammatory bowel disease (IBD) and iron deficiency anemia (IDA) in the Netherlands. The analysis indicated potential annual savings of €2.9 million on iron infusion costs alone and €28.2 million when including related costs and complications. The study utilized a casemix model based on hospital data over a 5-year horizon.
Abstract
<h4>Aims</h4>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 (<i>Diagnose Behandel Combinatie</i>) system. This study aims to elucidate the differences in budget impact, from a health insurers perspective.<h4>Materials and methods</h4>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.<h4>Results</h4>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.<h4>Limitations</h4>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.<h4>Conclusions</h4>Results showed that FDI significantly reduces healthcare expenditures versus FCM in patients with IBD and IDA in the Netherlands.
Background
This paper addresses the economic implications of using ferric derisomaltose versus ferric carboxymaltose for treating iron deficiency anemia in patients with inflammatory bowel disease. Previous studies have established the prevalence of IBD and the common occurrence of IDA in this population, necessitating effective treatment options. Understanding the budget impact from a health insurer's perspective is crucial for healthcare decision-making.
Methods
The study employed a casemix scenario analysis using hospital data from the DBC system to model the treatment costs associated with FDI and FCM. The analysis included relevant coding, tariffs, and volumes to assess the financial implications over a 5-year period. The primary outcome measure was the overall cost savings associated with the use of FDI compared to FCM.
Results
The analysis revealed that with the full use of FDI, the overall costs were lower than with FCM. Specifically, the potential annual savings excluding complications was €2.9 million, while including related costs and complications resulted in potential annual savings of €28.2 million. Sensitivity analyses confirmed the robustness of these findings.
Interpretation
The findings suggest that FDI may offer significant cost savings compared to FCM in the treatment of IDA in IBD patients. While the results are statistically significant, the clinical relevance of these savings in terms of patient outcomes is not directly addressed. Limitations such as potential underreporting in the DBC system and a 5-year analysis timeframe may confound the conclusions drawn.
Key findings
- Potential annual savings of €2.9 million on iron infusion cost only with full use of FDI.
- Including related costs and complications, potential annual savings are €28.2 million.
- The analysis was based on a casemix model using hospital data from the DBC system.
- The analysis timeframe was limited to 5 years.
- Sensitivity analyses proved the outcome to be robust.
Limitations
- The DBC system may show some underreporting.
- The analysis timeframe is limited to 5 years.