IngentaConnect Economic Evaluation of Voriconazole versus Caspofungin for the Tr...

Authors: Domínguez-Gil, Alfonso¹; Martín, Isabel²; Vargas, Mercedes García³; Almudena Del Castillo,⁴; Díaz, Silvia³; Sánchez, Cristina⁴

Source: Clinical Drug Investigation, Volume 27, Number 3, 2007 , pp. 197-205(9)

Publisher: Adis International

Abstract:

Background and objective: Invasive fungal infections are becoming increasingly prevalent and are more frequently the aetiological agents responsible for nosocomial infections. Since mid-2002, two new antifungal drugs - voriconazole, a third-generation azole, and caspofungin, a member of a new class of drugs called echinocandins - have been marketed in Spain. Both drugs have proven efficacy in the treatment of aspergillosis, are better tolerated than amphotericin B and are cheaper than liposomal amphotericin B. The objective of this study was to conduct an economic evaluation of voriconazole versus caspofungin for the treatment of invasive aspergillosis in Spain.

Methods: This was a cost-minimisation analysis (2006 costs) from the hospital perspective. Duration of treatment and bodyweight of patients were obtained from the Fungcost study and the incidence of adverse events was obtained from different published sources. Only direct costs were considered. Mean expected cost and incremental cost were calculated, and univariate and bivariate (bodyweight/treatment duration) sensitivity analyses were conducted.

Results: The mean expected cost per episode was euro6041.93 (intravenous treatment acquisition cost euro5524.75) for voriconazole and euro7174.05 (intravenous treatment acquisition cost euro6672.80) for caspofungin in invasive aspergillosis; the incremental cost was euro1132.18. Results were robust for any treatment duration and sensitive to bodyweights <103.42kg.

Conclusion: Voriconazole is a more cost-effective option than caspofungin in invasive aspergillosis in patients with a bodyweight <103.42kg.

Keywords: Antifungals; Aspergillosis; Caspofungin; Cost analysis; Cost minimisation; Voriconazole

Document Type: Research article

Affiliations: 1: 1 Servicio de Farmacia, Hospital Universitario de Salamanca, Salamanca, Spain 2: 2 Servicio de Farmacia, Hospital Juan Canalejo, La Coruña, Spain 3: 3 Medical Unit, Euroclin Institute, Madrid, Spain 4: 4 Health Outcomes Research Department, Medical Unit, Pfizer Spain, Alcobendas, Spain

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Economic Evaluation of Voriconazole versus Caspofungin for the Treatment of Invasive Aspergillosis in Spain