Cost-effectiveness analysis of anidulafungin in the treatment of candidaemia

Auzinger, G.; Playford, Geoffrey; Graham, Christopher N.; Narula, Himanshu; Charbonneau, Claudie; Weinstein, Debra F.; Kantecki, Michal; Schlamm, Haran T.; Ruhnke, Markus

doi:10.1186/cc12025

Cited by 1 publication

(1 citation statement)

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“… 35 Anidulafungin was also cost-effective versus fluconazole in the treatment of candidemia, according to a study in the UK published in 2013. 36 In a decision-analysis model carried out in Australia, it was found that despite the fact that the prescription of anidulafungin being associated with higher costs than fluconazole (AU$74,587 versus AU$ 60,945), when examining the mortality rates attributable to both drugs, anidulafungin showed that for an increase of 0.53 life-years gained, the incremental cost-effectiveness ratio would be AU$25,740 per year of life saved, a figure considered below the threshold of costs in that country. 37 Echinocandins are the recommended first-line treatment for candidemia and/or IC, given their clinical efficacy and safety.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of three echinocandins and fluconazole in the treatment of candidemia and/or invasive candidiasis in nonneutropenic adult patients

Grau¹,

Pozo²,

Romá³

et al. 2015

CEOR

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ObjectiveTo estimate the cost-effectiveness of three echinocandins (anidulafungin, caspofungin, and micafungin) and generic fluconazole in the treatment of nonneutropenic adult patients with candidemia and/or invasive candidiasis in intensive care units in Spain.Materials and methodsA decision-tree model was applied. The success and safety (hepatic and renal adverse effects) of first-line treatments were obtained from meta-analyses and systematic reviews of clinical trials. In the case of failure, a second-line treatment (liposomal amphotericin B after the echinocandins, or one of the echinocandins after fluconazole) was administered. The duration of the treatments (14 days total) was established by a panel of clinical experts using the Delphi method and according to Infectious Diseases Society of America guidelines. The cost of the medications and renal toxicity were considered. Deterministic and probabilistic sensitivity analysis using Monte Carlo simulations were carried out.ResultsThe total cost of the treatment of candidemia and/or invasive candidiasis with anidulafungin, caspofungin, micafungin, and fluconazole was €5,483, €5,968, €6,231, and €2,088, respectively. Anidulafungin was the dominant treatment (more effective, less expensive) compared to micafungin and caspofungin. The cost of achieving one more patient successfully treated with anidulafungin, caspofungin, and micafungin compared to fluconazole was €17,199, €23,962, and €27,339, respectively. The result remained stable, despite modification of the duration of the first-line and second-line treatments, as well as most of the dosing regimens. The probabilistic analysis also remained stable.ConclusionIn accordance with this economic study, anidulafungin would produce savings and would be the dominant treatment compared with micafungin and caspofungin in nonneutropenic adult patients with candidemia and/or invasive candidiasis in intensive care units in Spain.

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Section: Discussionmentioning

confidence: 99%