Universität zu Köln

Solano, Carlos ORCID: 0000-0003-3702-0817, Slavin, Monica ORCID: 0000-0002-8443-314X, Shaul, Alissa J., Marks, David I., Cordonnier, Catherine, Cornely, Oliver A., Pagliuca, Antonio, Cragin, Lael, Jarque, Isidro, Garcia-Vidal, Carolina ORCID: 0000-0002-8915-0683, Sorensen, Sonja, Vanness, David J., Charbonneau, Claudie, Andoni Barrueta, Jon, Peral, Carmen, De Salas-Cansado, Marina and Bow, Eric J. (2017). Economic evaluation of azoles as primary prophylaxis for the prevention of invasive fungal infections in Spanish patients undergoing allogeneic haematopoietic stem cell transplant. Mycoses, 60 (2). S. 79 - 89. HOBOKEN: WILEY. ISSN 1439-0507

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Abstract

Patients undergoing allogeneic haematopoietic stem cell transplantation (alloHSCT) are at risk of developing invasive fungal infections (IFIs). Even with introduction of oral triazole antifungal agents (fluconazole, itraconazole, posaconazole and voriconazole) IFI-associated morbidity and mortality rates and economic burden remain high. Despite their proven efficacy, it is currently unknown which is the most cost--effective antifungal prophylaxis (AFP) agent. To determine the costs and outcomes associated with AFP, a decision-analytic model was used to simulate treatment in a hypothetical cohort of 1000 patients undergoing alloHSCT from the perspective of the Spanish National Health System. Generic itraconazole was the least costly AFP ((SIC) 162) relative to fluconazole ((SIC) 500), posaconazole oral suspension ((SIC) 8628) or voriconazole ((SIC) 6850). Compared with posaconazole, voriconazole was associated with the lowest number of breakthrough IFIs (36 vs 60); thus, the model predicted fewer deaths from breakthrough IFI for voriconazole (24) than posaconazole (33), and the lowest predicted costs associated with other licensed antifungal treatment and IFI treatment in a cohort of 1000. Voriconazole-resulted in cost savings of (SIC) 4707 per patient compared with posaconazole. Itraconazole demonstrated a high probability of being cost-effective. As primary AFP in alloHSCT patients 180 days posttransplant, voriconazole was more likely to be cost-effective than posaconazole regarding cost per additional IFI and additional death avoided.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Solano, Carlos UNSPECIFIED orcid.org/0000-0003-3702-0817 UNSPECIFIED Slavin, Monica UNSPECIFIED orcid.org/0000-0002-8443-314X UNSPECIFIED Shaul, Alissa J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Marks, David I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cordonnier, Catherine UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pagliuca, Antonio UNSPECIFIED UNSPECIFIED UNSPECIFIED Cragin, Lael UNSPECIFIED UNSPECIFIED UNSPECIFIED Jarque, Isidro UNSPECIFIED UNSPECIFIED UNSPECIFIED Garcia-Vidal, Carolina UNSPECIFIED orcid.org/0000-0002-8915-0683 UNSPECIFIED Sorensen, Sonja UNSPECIFIED UNSPECIFIED UNSPECIFIED Vanness, David J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Charbonneau, Claudie UNSPECIFIED UNSPECIFIED UNSPECIFIED Andoni Barrueta, Jon UNSPECIFIED UNSPECIFIED UNSPECIFIED Peral, Carmen UNSPECIFIED UNSPECIFIED UNSPECIFIED De Salas-Cansado, Marina UNSPECIFIED UNSPECIFIED UNSPECIFIED Bow, Eric J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-240993
DOI:	10.1111/myc.12552
Journal or Publication Title:	Mycoses
Volume:	60
Number:	2
Page Range:	S. 79 - 89
Date:	2017
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1439-0507
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HIGH-RISK PATIENTS; ANTIFUNGAL PROPHYLAXIS; COST-EFFECTIVENESS; HEMATOLOGICAL MALIGNANCIES; IMMUNOCOMPROMISED PATIENTS; SINGLE-CENTER; FLUCONAZOLE; RECIPIENTS; EPIDEMIOLOGY; ITRACONAZOLE Multiple languages Dermatology; Mycology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24099