Budget Impact Analysis of Oral Fisiogen Ferro Forte ® versus Intravenous Iron for the Management of Iron Deficiency in Chronic Kidney Disease in Spain

Clin Drug Investig. 2018 Sep;38(9):801-811. doi: 10.1007/s40261-018-0666-9.


Background: Iron deficiency is a frequent complication of chronic kidney disease (CKD) that is associated with a decrease in the quality of life of patients and an increase in the risk of other clinical complications. Iron therapy represents one of the fundamentals of patients with CKD. Sucrosomial® oral iron allows Fisiogen Ferro Forte® to be used in all patients who are intolerant to treatment by the oral route of administration, or who present with malabsorption of conventional oral iron preparations.

Objective: The main objective of this study was to assess the economic impact of the oral iron Fisiogen Ferro Forte® for the management of iron deficiency in CKD patients in Spain.

Methods: A 4-year budget impact model was developed for the period 2017-2020 for CKD patients with iron deficiency who were candidates for intravenous iron due to a lack of response to oral iron, from the perspective of the Spanish healthcare system. Three subgroups of CKD patients were included in the analysis: predialysis, peritoneal dialysis, and post-transplant. The intravenous iron formulations Ferinject®, Venofer®, and Feriv® were considered appropriate comparators to be used in the model. National data on the prevalence of CKD for the three subgroups of patients were obtained from the literature, and input data on drug utilization and outpatient hospitalizations associated with iron administration were obtained by consulting nephrologists. Nephrology experts were also asked about resources used during medical visits and monitoring tests. Based on the unit costs for each iron therapy and the resources used, the total treatment cost per patient associated with each product was obtained to estimate the global budget impact of increasing the use of Fisiogen Ferro Forte®.

Results: The average annual budget savings due to an increase in Fisiogen Ferro Forte® and a decrease in intravenous iron have been estimated at €398,685, €180,937, and €195,842 over 4 years for the predialysis, peritoneal dialysis, and post-transplant groups, respectively.

Conclusions: The increase in the use of Fisiogen Ferro Forte® leads to overall budget savings of €775,464 for the Spanish National Health Service over 4 years.

MeSH terms

  • Administration, Intravenous
  • Administration, Oral
  • Adult
  • Anemia, Iron-Deficiency / drug therapy*
  • Anemia, Iron-Deficiency / economics
  • Anemia, Iron-Deficiency / etiology
  • Budgets
  • Cost Savings
  • Ferric Compounds / economics
  • Ferric Compounds / therapeutic use*
  • Health Care Costs
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data
  • Humans
  • Iron / economics
  • Iron / therapeutic use*
  • Kidney Transplantation
  • Maltose / analogs & derivatives*
  • Maltose / economics
  • Maltose / therapeutic use
  • Models, Economic
  • Peritoneal Dialysis
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / drug therapy*
  • Renal Insufficiency, Chronic / economics
  • Spain


  • Ferric Compounds
  • ferric carboxymaltose
  • Maltose
  • Iron