Universität zu Köln

Heimann, Sebastian M., Cornely, Oliver A., Vehreschild, Maria J. G. T., Glossmann, Jan, Kochanek, Matthias, Kreuzer, Karl-Anton, Hallek, Michael and Vehreschild, Joerg J. (2014). Treatment cost development of patients undergoing remission induction chemotherapy: a pharmacoeconomic analysis before and after introduction of posaconazole prophylaxis. Mycoses, 57 (2). S. 90 - 98. HOBOKEN: WILEY. ISSN 1439-0507

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Abstract

Prior clinical trials have demonstrated efficacy and effectiveness of posaconazole in the prophylaxis of invasive fungal diseases in high-risk patients. Controversy exists about the cost-effectiveness of this approach. We performed an analysis comparing the direct costs of posaconazole prophylaxis against polyene mouthwash (thrush) prophylaxis in patients with acute myelogenous leukaemia (AML). Data of AML patients receiving remission-induction chemotherapy were extracted from the CoCoNut (Cologne Cohort of Neutropenic Patients) database to compare hospital costs of patients before (2003-2005) and after (2006-2008) introduction of posaconazole prophylaxis. Treatment on general ward, intensive care unit (ICU), mechanical ventilation, diagnostic procedures, and all anti-infectives were calculated. Patient groups were well matched according to age, gender and duration of neutropenia. The mean costs per patient in the posaconazole group (n=76) and the polyene mouthwash group (n=81) were Euro21040 (95% confidence interval (CI): Euro18204-Euro23876) and Euro23169 (95% CI: Euro19402-Euro26937) per patient. Antifungal treatment costs were Euro4580 (95% CI: Euro3678-Euro5482) and Euro4019 (95% CI: Euro2825-Euro5214). Duration on the ICU was 2582 (95% CI: 984.1-4181.7) and 5517 (95% CI: 2206-8827.3) min. In our hospital, primary antifungal prophylaxis by posaconazole was cost-effective. There was a trend towards cost savings, which was primarily caused by a shorter overall length of stay and the less frequent ICU treatment.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Heimann, Sebastian M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Maria J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Glossmann, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Kochanek, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Kreuzer, Karl-Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Joerg J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-447367
DOI:	10.1111/myc.12105
Journal or Publication Title:	Mycoses
Volume:	57
Number:	2
Page Range:	S. 90 - 98
Date:	2014
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1439-0507
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INVASIVE FUNGAL DISEASE; MYELOGENOUS LEUKEMIA AML; ACUTE MYELOID-LEUKEMIA; INTENSIVE-CARE UNITS; ITRACONAZOLE PROPHYLAXIS; NEUTROPENIC PATIENTS; FLUCONAZOLE; INFECTIONS; ASPERGILLOSIS; PREVENTION Multiple languages Dermatology; Mycology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44736