Comparative Cost-Effectiveness Analysis of Isavuconazole vs. Voriconazole for the Treatment of Invasive Aspergillosis in Algerian Hospital Setting

Author(s)

Nassima Achour, MD1, Mourad OUALI, MD2, Rihab Al-Homsi, Pharm.D3, YACINE HAMMAS, Pharm.D4, Nimer Alkhatib, PhD5, Ahmad Aburmilah, M.Sc3, Jalal Kamel Atieh, BScPharm3.
1Infectious Diseases Department at El Hadi FLICI Hospital, Algiers, Algeria, 2Medical ICU at Mustapha BACHA Hospital, Algiers, Algeria, 3Hikma Pharmaceuticals, Amman, Jordan, 4Hikma Pharmaceuticals, Algiers, Algeria, 5Path Economics, Amman, Jordan.

Presentation Documents

OBJECTIVES: This study aims to assess the potential cost-effectiveness of Isavuconazole versus Voriconazole for the treatment of Invasive Aspergillosis (IA) in Algerian hospital setting.
METHODS: A cost-utility analysis using a decision tree model was conducted from Algerian hospital payer perspective. Patients with possible IA entered the model, with 6% estimated to actually have mucormycosis. Only direct medical costs were considered, including cost of medications acquisition, intravenous administration, treatment switching, step-down therapy, nephrotoxicity management, and laboratory monitoring. Data were drawn from the literature (randomized clinical trials, observational studies, international guidelines) then adjusted to local clinical practices. Local drug prices were Isavuconazole 200mg vial (USD 297.82), Isavuconazole 100mg 14 capsules (USD 495.27), Voriconazole 200mg vial (USD 58.20) and Voriconazole 200mg 30 tablets (USD 143.77), exchange rate (1 USD = 137 DZD). Medical resource utilization cost was estimated from Algerian healthcare data. Deterministic and probabilistic sensitivity analyses were performed. Results were extrapolated over the lifetime horizon of hematological malignancy patients.
RESULTS: The total cost of Isavuconazole was USD 9,794.06 for IA treatment and USD 1,238.78 for patients with Mucormycosis. The total cost of Voriconazole for the treatment of IA and IM was USD 6,715.01 and USD 1,447.05, respectively. We assumed that 10% of patients remain on Voriconazole despite having Mucormycosis. The combined estimated QALY associated with Isavuconazole treatment and Voriconazole treatment for IA and IM was 7.18 QALY and 6.24 QALY, respectively. The ICER for the use of Isavuconazole versus Voriconazole for the treatment of IA was USD 3,059.10 per QALY gained. Model sensitivity was highest to Isavuconazole vial price. PSA confirmed that Isavuconazole was 80% cost-effective at willingness-to-pay threshold of 6000 USD/QALY which is below three times the GDP per capita for Algeria.
CONCLUSIONS: Isavuconazole is a cost-effective treatment option for IA in Algerian hospital setting. These findings may support its introduction strategy to Algerian market.

Conference/Value in Health Info

2025-11, ISPOR Europe 2025, Glasgow, Scotland

Value in Health, Volume 28, Issue S2

Code

EE139

Topic

Economic Evaluation

Disease

Infectious Disease (non-vaccine)

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