Comprehensive Clinical Evaluation of Amphotericin B in the Treatment of Invasive Fungal Disease 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: To develop a clinical comprehensive evaluation index system for the treatment of invasive fungal disease (IFD) and to conduct empirical research to provide methodological references for rational clinical use in hospitals.
METHODS: Based on literature review and relevant guidelines, the Delphi method was used to construct a clinical comprehensive evaluation index system and evaluation criteria for the treatment of invasive fungal infections. Conventional amphotericin B (AmB), liposomal amphotericin B (L-AmB), and amphotericin B colloidal dispersion (ABCD) were included as examples in the empirical research.
RESULTS: Following expert validation, six primary indicators and thirteen secondary indicators were finalized along with their corresponding weights and quantitative scoring. According to the collected evidence, the clinical comprehensive value scores of ABCD, L-AmB and AmB were 73.50, 70.50, and 49.50, respectively. ABCD demonstrated economic advantages including a lower daily cost and a reduced incremental cost-effectiveness ratio (ICER). L-AmB demonstrated superior efficacy and received higher recommendation grades in both domestic and international guidelines. In contrast, AmB received significantly lower scores in safety and guideline recommendation domains, primarily due to adverse events such as nephrotoxicity.
CONCLUSIONS: The proposed clinical evaluation index system offers a structured and evidence-based approach for guiding antifungal drug selection. Among the assessed formulations, ABCD provides the best economic value, while L-AmB offers the highest clinical efficacy. These findings can provide a reference for rational drug use in clinical practice.
METHODS: Based on literature review and relevant guidelines, the Delphi method was used to construct a clinical comprehensive evaluation index system and evaluation criteria for the treatment of invasive fungal infections. Conventional amphotericin B (AmB), liposomal amphotericin B (L-AmB), and amphotericin B colloidal dispersion (ABCD) were included as examples in the empirical research.
RESULTS: Following expert validation, six primary indicators and thirteen secondary indicators were finalized along with their corresponding weights and quantitative scoring. According to the collected evidence, the clinical comprehensive value scores of ABCD, L-AmB and AmB were 73.50, 70.50, and 49.50, respectively. ABCD demonstrated economic advantages including a lower daily cost and a reduced incremental cost-effectiveness ratio (ICER). L-AmB demonstrated superior efficacy and received higher recommendation grades in both domestic and international guidelines. In contrast, AmB received significantly lower scores in safety and guideline recommendation domains, primarily due to adverse events such as nephrotoxicity.
CONCLUSIONS: The proposed clinical evaluation index system offers a structured and evidence-based approach for guiding antifungal drug selection. Among the assessed formulations, ABCD provides the best economic value, while L-AmB offers the highest clinical efficacy. These findings can provide a reference for rational drug use in clinical practice.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HTA86
Topic
Health Technology Assessment
Topic Subcategory
Value Frameworks & Dossier Format
Disease
Infectious Disease (non-vaccine)