Economic evaluation of micafungin vs. Liposomal Amphotericin B (LAmB) for the treatment of candidaemia and Invasive Candidiasis (IC)

Mycoses - Tập 56 Số 5 - Trang 532-542 - 2013
Chin Fen Neoh1,2, Danny Liew3, Monica A. Slavin4, Debbie Marriott5, Sharon C‐A Chen6, Orla Morrissey7, Kay Stewart1, David C. M. Kong1
1Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University (Parkville Campus), Parkville, Australia
2Faculty of Pharmacy, University of Technology Mara, Penang, Malaysia
3Department of Medicine, Melbourne EpiCentre, University of Melbourne, Royal Melbourne Hospital, Parkville, Australia
4Department of Infectious Diseases, Peter MacCallum Cancer Centre, East Melbourne, Australia
5Department of Clinical Microbiology and Infectious Diseases, St Vincent's Hospital, Darlinghurst, Australia
6Centre for Infectious Diseases and Microbiology, Westmead Hospital, Wentworthville, Australia
7Department of Medicine, Infectious Diseases Unit, Alfred Health and Monash University, Melbourne, Australia

Tóm tắt

SummaryMicafungin was non‐inferior to liposomal amphotericin B (LAmB) for the treatment of candidaemia and invasive candidiasis (IC) in a major clinical trial. The present study investigated the economic impact of micafungin vs.LAmB in treating candidaemia andIC. A decision analytical model was constructed to capture downstream consequences of using micafungin orLAmB as primary definitive therapy. The main outcomes were treatment success and treatment failure due to mycological persistence, or death. Outcome probabilities were derived from key published sources. Resource used was estimated by an expert panel and cost inputs were from the latest Australian resources. The analysis was from an Australian hospital perspective. Sensitivity analyses using Monte Carlo simulation were conducted. Micafungin (AU$61 426) had a lower total cost thanLAmB (AU$72 382), with a total net cost‐saving ofAU$10 957 per patient. This was primarily due to the lower cost associated with initial antifungal treatment and shorter length of stay for patients in the micafungin arm. Hospitalisation was the main cost driver for both arms. Results were robust over a wide range of variables. The uncertainty analysis demonstrated that micafungin had a 99.9% chance of being cost‐saving compared withLAmB. Micafungin was associated with cost‐saving relative toLAmB in the treatment of candidaemia andICin Australia.

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Mycoses

Tập 56 Số 5

532-542

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