Cost-Utility Analysis of Amphotericin B Formulations for Invasive Fungal Disease in Hematologic Patients in China
Author(s)
Chuxin Zhao, MSc Candidate1, Liping Chen, MSc1, ZHIHAO XU, PhD (in progress)2, Yue Yu, Doctor3, Jianwei Xuan, PhD1.
1Institute of Health Economics, School of Pharmacy, Sun Yat-sen University, Guangzhou, China, 2Dong Furen Institute of Economic and Social Development, Wuhan University, Wuhan, China, 3Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai, China.
1Institute of Health Economics, School of Pharmacy, Sun Yat-sen University, Guangzhou, China, 2Dong Furen Institute of Economic and Social Development, Wuhan University, Wuhan, China, 3Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai, China.
OBJECTIVES: This study aims to evaluate the cost-utility of three antifungal therapies—conventional amphotericin B (AmB), amphotericin B colloidal dispersion (ABCD), and liposomal amphotericin B (L-AmB)—for the treatment of invasive fungal disease (IFD) in hematologic patients in China. The findings are intended to support policy decisions regarding antifungal treatment strategies.
METHODS: A cost-utility analysis was conducted from the perspective of the Chinese healthcare system over a one-year horizon. A short-term decision tree model was constructed in Excel with three mutually exclusive health states: (1) treatment effective, (2) treatment ineffective but alive, and (3) treatment ineffective and deceased. Model inputs—response rates, mortality, adverse event rates, utility values, and direct medical costs—were obtained from published literature, official drug prices, and expert opinions. Only direct medical costs were considered, including drug acquisition, administration costs, adverse event management, and diagnostics. Incremental cost-effectiveness ratios (ICERs) were calculated for each strategy. One-way sensitivity analysis tested the stability of results.
RESULTS: Compared with AmB, ABCD showed an incremental cost of ¥8,613 and a QALY gain of 0.158, yielding an ICER of ¥54,672/QALY. L-AmB showed an incremental cost of ¥16,761 and a QALY gain of 0.218, with an ICER of ¥76,933/QALY. Both ICERs were below the willingness-to-pay threshold of one-time per capita GDP in China. Sensitivity analysis identified key influencing factors such as treatment duration and response rates but did not alter the overall conclusions.
CONCLUSIONS: ABCD and L-AmB are cost-effective alternatives to AmB for IFD treatment in hematologic patients in China. Based on the cost-utility results, ABCD provides the greatest health benefit per unit cost, supporting its prioritization in clinical and policy settings.
METHODS: A cost-utility analysis was conducted from the perspective of the Chinese healthcare system over a one-year horizon. A short-term decision tree model was constructed in Excel with three mutually exclusive health states: (1) treatment effective, (2) treatment ineffective but alive, and (3) treatment ineffective and deceased. Model inputs—response rates, mortality, adverse event rates, utility values, and direct medical costs—were obtained from published literature, official drug prices, and expert opinions. Only direct medical costs were considered, including drug acquisition, administration costs, adverse event management, and diagnostics. Incremental cost-effectiveness ratios (ICERs) were calculated for each strategy. One-way sensitivity analysis tested the stability of results.
RESULTS: Compared with AmB, ABCD showed an incremental cost of ¥8,613 and a QALY gain of 0.158, yielding an ICER of ¥54,672/QALY. L-AmB showed an incremental cost of ¥16,761 and a QALY gain of 0.218, with an ICER of ¥76,933/QALY. Both ICERs were below the willingness-to-pay threshold of one-time per capita GDP in China. Sensitivity analysis identified key influencing factors such as treatment duration and response rates but did not alter the overall conclusions.
CONCLUSIONS: ABCD and L-AmB are cost-effective alternatives to AmB for IFD treatment in hematologic patients in China. Based on the cost-utility results, ABCD provides the greatest health benefit per unit cost, supporting its prioritization in clinical and policy settings.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE300
Topic
Economic Evaluation
Disease
Infectious Disease (non-vaccine)