ISBN: Table 57: Cost of IV iron therapy Regimen Drug cost ( ) Nurse time per infusion, minutes Nurse cost ( ) (b) Other ( ) Total ( ) Tria l Drug Iron mg/ vial Vials /visit No. visits Cost/ vial (a) Total drug cost Preparation Infusio n Observatio n Cost per visit Total cost Consumable s Transport Admin time and clinic space FAIR-HF Ferric Carboxy- maltose Ferric Carboxy- maltose CONFIRM-HF Ferric Carboxy- maltose Ferric Carboxy- maltose IRON-HF Iron Sucrose (infusion ) (a) BNF, May 2016161 Chronic Heart Failure Treating Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 6.2.5.5 Evidence statements Clinical Five studies were identified for inclusion within the review. Four trials compared IV iron with placebo; 1 of which also included an oral iron arm. A further single study compared oral iron with placebo. Two of the trials were in patients with anaemia; the other 3 trials included both anaemic and non-anaemic patients. The evidence ranged from high to very low quality. Evidence was downgraded for a number of reasons including risk of bias, imprecision due to wide confidence intervals surrounding the effect estimate and indirectness of the reported outcome. For the comparison of IV iron with placebo a number of the outcomes were rated as high quality evidence . These included QoL (as measured by the EQ5D scale (n=459) and MLWHFQ (n=40)) and the haemoglobin level in people with anaemia (n=60). These outcomes all showed a clinically important symptomatic benefit of IV iron. Moderate quality evidence was found for the outcomes exercise tolerance (n=688) and systolic blood pressure (n=60) both of which suggested no clinical effect of IV iron. The remaining outcomes were all rated as low or very low quality evidence. 