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2015 ; 15
(ä): 463
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Cost-effectiveness analysis of anidulafungin for the treatment of candidaemia and
other forms of invasive candidiasis
#MMPMID26503366
Auzinger G
; Playford EG
; Graham CN
; Knox HN
; Weinstein D
; Kantecki M
; Schlamm H
; Charbonneau C
BMC Infect Dis
2015[Oct]; 15
(ä): 463
PMID26503366
show ga
BACKGROUND: Candidaemia and other forms of invasive candidiasis (C/IC) in the
intensive care unit are challenging conditions that are associated with high
rates of mortality. New guidelines from the European Society for Clinical
Microbiology and Infectious Diseases strongly recommend echinocandins for the
first-line treatment of C/IC. Here, a cost-effectiveness model was developed from
the United Kingdom perspective to examine the costs and outcomes of antifungal
treatment for C/IC based on the European Society for Clinical Microbiology and
Infectious Diseases guidelines. METHODS: Costs and treatment outcomes with the
echinocandin anidulafungin were compared with those for caspofungin, micafungin
and fluconazole. The model included non-neutropenic patients aged ?16 years with
confirmed C/IC who were receiving intravenous first-line treatment. Patients were
categorised as either a clinical success or failure (patients with
persistent/breakthrough infection); successfully treated patients switched to
oral therapy, while patients categorised as clinical failures switched to a
different antifungal class. Other inputs were all-cause mortality at 6 weeks,
costs of treatment-related adverse events and other medical resource utilisation
costs. Resource use was derived from the published literature and from discussion
with clinical experts. Drug-acquisition/administration costs were taken from
standard United Kingdom costing sources. RESULTS: The model indicated that
first-line anidulafungin could be considered cost-effective versus fluconazole
(incremental cost-effectiveness ratio £813 per life-year gained) for the
treatment of C/IC. Anidulafungin was cost-saving versus caspofungin and
micafungin due to lower total costs and a higher rate of survival combined with a
higher probability of clinical success. DISCUSSION: European Society for Clinical
Microbiology and Infectious Diseases guidelines recommend echinocandins for the
first-line treatment of C/IC; our model indicated that anidulafungin marries
clinical effectiveness and cost-effectiveness. CONCLUSIONS: From the United
Kingdom perspective, anidulafungin was cost-effective compared with fluconazole
for the treatment of C/IC and was cost-saving versus the other echinocandins.
|Anidulafungin
[MESH]
|Antifungal Agents/adverse effects/economics/therapeutic use
[MESH]