Background: Ferric carboxymaltose (FCM) treatment in case of iron deficient (ID) patients with chronic heart failure (CHF) has shown great promise according to the findings of recent studies in improvement of symptoms and quality of life, New York Heart Association (NYHA) classifica- tion, and exercise capacity. Aim of the study: The purpose of the current study is to assess the budget impact of treating CHF patients with FCM in a sample of Romanian hospitals. Material and methods: Calculations have been based on the budget impact model developed by Theidel et al. The assumptions and clinical outcomes of the current study were based on a multivariate statisti- cal approach used in the same German study. The predicted outcomes were based on data pooled from four double-blind randomized controlled trials. The time horizon of the model was 1 year. Budget impact calculations were performed from the public payer perspective. Two scenarios have been handled: one without applying the Clawback tax and one with applying the tax to the cost of medication. Results: The yearly budget impact of FCM vs. no iron-replacement treatment without applying the tax ranged between €678,383 and €641,588 for 1,000 patients, resulting in €37 of additional costs per patient per year. The yearly budget impact of FCM vs. no iron-replacement treatment with applying the tax ranged between €616,934 and €641,588 for 1,000 patients, re- sulting in €9 of cost reduction per patient per year. Key cost drivers included the cost of outpatient visits and the cost of hospitalization due to HF worsening. Sensitivity analysis for both scenarios proved the robustness of the results. Conclusions: The FCM treatment of CHF patients has a mod-erate budget impact. Moreover, this budget impact/saving translates into a reduction of the rate and length of hospitalization stay and a better symptomatic profile of the patients.