OBJECTIVES: A cost-effectiveness model was developed to evaluate use of SUBA-ITRA to treat systemic mycoses (SM) in adult patients from a U.S. payer perspective.

METHODS: A decision-tree model was constructed to evaluate a hypothetical cohort of patients initiating either SUBA-ITRA or ITRA and consisted of seven health states: Diagnosis, Treatment for SM (oral therapy), Stabilization, Relapse, Discontinuation, Cure, and Mortality. Due to the acute nature of the disease, a five-year horizon was used. Probabilities of being in each health state with either SUBA-ITRA or ITRA were derived from clinical trial publications, treatment guidelines, product prescribing information, and a targeted survey of key opinion leaders (KOLs) currently treating SM. Treatment response was calculated from frequentist indirect-treatment-comparison of clinical trial data. Model utilities were based on clinical trial EQ-5D measurements reported for the different phases of treatment. For each treatment, drug costs and additional costs related to healthcare resource use, adverse events, indirect (productivity) costs, and mortality were included. The primary economic endpoints were cost per life year (LY) and cost per quality-adjusted life year (QALY).

RESULTS: Over a five-year horizon, the total cost of treating one patient with SUBA-ITRA was estimated at $224,554, compared with $228,087 for ITRA. Comparing SUBA-ITRA vs ITRA, QALYs (3.31 vs 3.22) and LYs (2.97 vs 2.89) were similar but higher for SUBA-ITRA, resulting in SUBA-ITRA dominance over ITRA. Deterministic and probabilistic sensitivity analyses generally showed consistency with base case findings.

CONCLUSIONS: Data were applied from published clinical evidence and guidelines, as well as a KOL survey of physicians. SUBA-ITRA estimates were associated with small gains in benefits, which resulted in SUBA-ITRA dominance over ITRA in the base case. Sensitivity analyses supported the findings and contributed to the robustness of the economic model.