OBJECTIVES:

Invasive mold diseases (IMDs) are associated with significant morbidity and mortality. Its diagnosis is given in different hospital units, including hematology and transplants, but mainly in critical care units, where it is important to start the most suitable treatment as quickly as possible. Isavuconazole (ISAV) has been positioned as a preferred therapeutic option in certain patient profiles. An economic model was developed to help inform treatment decisions for IMD cases in which voriconazole is considered unsuitable, to explore the cost with ISAV versus liposomal amphotericin B followed by posaconazole (L-AMB→POSA) in Spain.

METHODS:

As indirect comparisons have demonstrated similar efficacy between the comparators, a cost-minimization approach was taken. Drug acquisition, administration, hospitalization, laboratory tests and adverse events costs were evaluated from the Spanish National Healthcare System (NHS) perspective.

RESULTS:

Total costs per-patient were 24,715.54€ with ISAV versus 29,753.53€ with L-AMB→POSA. Savings were driven mainly by drug acquisition costs (-33.0%; 8,195.50€ vs 12,017.76€; -4,029.25€) but also in the use of healthcare resource costs (-5.8%; 16,520.04€ vs 17,528.78€; -1,008.74€). All direct costs were lower with ISAV than with L-AMB→POSA: IV administration (109.67€ vs 463.84€), laboratory tests (21.00€ vs 165.00€) and adverse events (108.11€ vs 618.67€), except in hospitalization due to the assumption to be similar in both arms. IMD treatment costs remained lower for ISAV than for L-AMB→POSA across all sensitivity analyses (-18,829.37€ to -326.59€), being the L-AMB posology the most influence parameter.

CONCLUSIONS:

ISAV has the potential to substantial save costs on the IMD management relative to L-AMB→POSA, enable not switching to another therapeutic class. It is necessary to approach IMD diagnosis and treatment from a holistic point of view. This analysis would enable healthcare professionals to make informed therapeutic decisions based on most efficient therapy within the Spanish PROA (antibiotic use optimization programs) hospital teams.