Cost-effectiveness analysis of anidulafungin vs fluconazole for the treatment of invasive candidiasis (IC) in Turkey


Neoh C. F., ŞENOL E., KARA A., DİNLEYİCİ E. Ç., Turner S. J., Kong D. C. M.

MYCOSES, vol.60, no.11, pp.714-722, 2017 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 60 Issue: 11
  • Publication Date: 2017
  • Doi Number: 10.1111/myc.12651
  • Journal Name: MYCOSES
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.714-722
  • Keywords: antifungals, Candida spp, modelling, LIPOSOMAL AMPHOTERICIN-B, CRITICALLY-ILL PATIENTS, RISK-FACTORS, RESOURCE UTILIZATION, ECONOMIC-EVALUATION, FUNGAL-INFECTIONS, CANDIDEMIA, CANDIDAEMIA, CASPOFUNGIN, SEPSIS
  • Gazi University Affiliated: Yes

Abstract

Anidulafungin has been shown to be non-inferior to, and possibly more efficacious, than fluconazole in treating patients with invasive candidiasis (IC). This study aimed to determine the cost-effectiveness of anidulafungin vs fluconazole for treatment of IC in the Turkish setting. A decision analytic model was constructed to depict downstream economic consequences of using anidulafungin or fluconazole for treatment of IC in the Turkish hospitals. Transition probabilities (ie treatment success, observed or indeterminate treatment failures) were obtained from a published randomised clinical trial. Cost inputs were from the latest Turkish resources. Data not available in the literature were estimated by expert panels. Sensitivity analyses were performed to assess the robustness of the model outcome. While anidulafungin [TL 17171 (USD 4589)] incurred a higher total cost than fluconazole [TL 8233 (USD 2200) per treated patient, treatment with anidulafungin was estimated to save an additional 0.58 life-years, with an incremental cost-effectiveness ratio of TL 15410 (USD 4118) per life-years saved. Drug acquisition cost and hospitalisation were the main cost drivers for anidulafungin and fluconazole arms respectively. The model findings were robust over a wide range of input variables except for anidulafungin drug cost. Anidulafungin appears to be a cost-effective therapy in treating IC from the Turkish hospital perspective.