A216 THE COST-EFFECTIVENESS OF FERRIC DERISOMALTOSE VERSUS FERRIC CARBOXYMALTOSE IN THE TREATMENT OF IRON DEFICIENCY ANAEMIA IN CANADA
Bibliographic record
Abstract
Abstract Background In Canada, approximately 0.8% of people have inflammatory bowel disease (IBD), which is estimated to rise by 2.4% annually over the next decade. Iron deficiency anaemia (IDA) is common in people with IBD, who can experience high levels of fatigue that may be alleviated by iron treatment. Intravenous (IV) iron is recommended for people who are intolerant or unresponsive to oral iron or those who require iron rapidly. Ferric carboxymaltose (FCM) and ferric derisomaltose (FDI) are high-dose, rapid-infusion iron formulations approved for treatment of IDA in people with IBD. Aims To evaluate the cost-utility of FDI versus FCM when treating IDA in patients with IBD in Canada. Methods A published model was adapted to evaluate the cost-utility of FDI versus FCM in Canada. Joint distributions of bodyweight and haemoglobin were used alongside the product monographs (PMs) to model iron need. Iron supply models for FCM and FDI were developed based on posological information in the PMs. Disease-related quality of life (QoL) was modelled using SF-36 data from the PHOSPHARE-IBD randomized trial and a diminishing marginal utility model was used to estimate the effect of iron infusions on QoL. Costs were obtained from Canadian sources aligned with a previous CDA-AMC appraisal of FDI. Price parity between FCM and FDI was assumed, and indirect costs arising from attending IV iron infusions were captured. Analyses were run over 10 years, costs were expressed in 2023 Canadian dollars ($), and future costs and effects were discounted at 1.5% per annum. Scenario analyses were performed incorporating fracture incidence based on recent data showing elevated fracture risk after administration of FCM versus FDI. Results Relative to FCM, FDI was associated with an additional 0.147 QALYs over 10 years, driven primarily by differences in disease-related QoL (Table). Costs were lower with FDI than FCM ($7,630 versus $9,236), corresponding to a saving of $1,606 per patient over 10 years driven by a reduced number of infusions required to correct iron need with FDI (11.13 versus 14.21 with FCM), and no requirement to monitor phosphate after FDI (Figure). FDI was therefore the dominant intervention. In the fracture scenario analysis, fracture risk was similar before and after treatment with FDI, but was higher with FCM, accompanied by additional costs of $3,086 versus FDI over 10 years ($4,285 versus $1,199). Conclusions In people with IBD and IDA requiring IV iron, FDI dominated FCM, reducing costs while improving QoL. Contributors to QoL over 10 years Direct cost drivers in the base case analysis and indirect costs in the societal analysis Funding Agencies Pharmacosmos A/S
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".