Cost-Effectiveness Analysis of Isavuconazole vs. Voriconazole for the Treatment of Invasive Aspergillosis in Morocco
Author(s)
Amr Maoujoudi, MD, PhD1, Maha Soussi Abdellaoui, MD2, Rihab Al-Homsi, Pharm.D3, Nimer Alkhatib, PhD4, Ahmad Aburmilah, M.Sc3, Bouchra Essaoui, B.Pharm5, Jalal Kamel Atieh, BSc Pharm3.
1Faculty of medicine Mohammed V University rabat Morocco, Rabat, Morocco, 2CHU Ibn Rochd, Hassan II University of Casablanca, Casablanca, Morocco, 3Hikma Pharmaceuticals, Amman, Jordan, 4Path Economics, Amman, Jordan, 5Hikma Pharmaceuticals, Casablanca, Morocco.
1Faculty of medicine Mohammed V University rabat Morocco, Rabat, Morocco, 2CHU Ibn Rochd, Hassan II University of Casablanca, Casablanca, Morocco, 3Hikma Pharmaceuticals, Amman, Jordan, 4Path Economics, Amman, Jordan, 5Hikma Pharmaceuticals, Casablanca, Morocco.
Presentation Documents
OBJECTIVES: Invasive Aspergillosis (IA) is a severe fungal infection with high morbidity and mortality, particularly among immunocompromised patients. The selection of an optimal antifungal treatment is essential to improve clinical outcomes and ensure efficient use of healthcare resources. Isavuconazole, a novel broad-spectrum azole, has recently been introduced in Morocco. This study aims to evaluate the cost-effectiveness of isavuconazole compared to voriconazole for the treatment of IA from Moroccan healthcare payer perspective.
METHODS: A cost-utility analysis using a decision tree model was conducted. Patients with possible IA entered the model, with 5% 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 and clinical definitions were sourced from published clinical trials and medical guidelines then adapted to Moroccan context and local epidemiological data. Both deterministic (DSA) and probabilistic sensitivity analyses (PSA) were performed to assess parameter uncertainty and test model robustness. Results were extrapolated over the lifetime horizon of hematological malignancy patients.
RESULTS: The total cost of isavuconazole was 13,964.57 USD for IA and 2,860.05 USD for mucormycosis. For voriconazole, the costs were 9,886.44 USD and 5,712.68 USD, respectively. Local experts estimated that 10% patients remain on Voriconazole despite having mucormycosis. The QALYs gained were 7.19 for Isavuconazole and 6.29 for Voriconazole. The incremental cost-effectiveness ratio (ICER) of Isavuconazole versus Voriconazole was 1,357.05 USD per QALY gained. Model sensitivity was highest to switching probability of voriconazole to liposomal amphotericin in case of Mucormycosis and survival rates in IA. PSA confirmed Isavuconazole is 80% cost-effective at willingness-to-pay threshold of 3,500 USD/QALY which is below three times the GDP per capita for Morocco.
CONCLUSIONS: Isavuconazole is a cost-effective treatment for IA in Morocco. These findings support its use in clinical practice and may support clinicians in optimizing therapeutic decisions.
METHODS: A cost-utility analysis using a decision tree model was conducted. Patients with possible IA entered the model, with 5% 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 and clinical definitions were sourced from published clinical trials and medical guidelines then adapted to Moroccan context and local epidemiological data. Both deterministic (DSA) and probabilistic sensitivity analyses (PSA) were performed to assess parameter uncertainty and test model robustness. Results were extrapolated over the lifetime horizon of hematological malignancy patients.
RESULTS: The total cost of isavuconazole was 13,964.57 USD for IA and 2,860.05 USD for mucormycosis. For voriconazole, the costs were 9,886.44 USD and 5,712.68 USD, respectively. Local experts estimated that 10% patients remain on Voriconazole despite having mucormycosis. The QALYs gained were 7.19 for Isavuconazole and 6.29 for Voriconazole. The incremental cost-effectiveness ratio (ICER) of Isavuconazole versus Voriconazole was 1,357.05 USD per QALY gained. Model sensitivity was highest to switching probability of voriconazole to liposomal amphotericin in case of Mucormycosis and survival rates in IA. PSA confirmed Isavuconazole is 80% cost-effective at willingness-to-pay threshold of 3,500 USD/QALY which is below three times the GDP per capita for Morocco.
CONCLUSIONS: Isavuconazole is a cost-effective treatment for IA in Morocco. These findings support its use in clinical practice and may support clinicians in optimizing therapeutic decisions.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE210
Topic
Economic Evaluation
Disease
Infectious Disease (non-vaccine)