OBJECTIVES: To investigate the economic impact of introducing micafungin (MICA) for the treatment of systemic candida infections (SCIs) (including invasive candidiasis and candidaemia) in Italy, a health economic analysis was performed comparing MICA with liposomal amphotericin B (L‑AMB). METHODS: The model was based on data from a phase III, randomised, double‑blind trial comparing MICA with L‑AMB. The model entailed a period of 14‑20 weeks from initiation of treatment and was analysed from an Italian hospital perspective. The analysis included hospitalisation and primary medication costs. Unit costs of these resources were taken from Italian costing sources. As the price for MICA was not available at the time of analysis, the price per recommended daily dose (RDD) of MICA (100 mg) was assumed to be equal to the price per RDD of caspofungin (50 mg). The model endpoint was defined as the percentage of patients predicted to achieve complete or partial clinical and mycological response after initial treatment, and be alive after the 12‑week follow‑up period. The model was analysed using cohort and second‑order Monte Carlo (MC) simulation. RESULTS: The analysis of this model shows that with MICA 52.9% of patients were predicted to have treatment success and survive 12 weeks after end of treatment compared with 49.1% for L‑AMB. MICA was predicted to be less expensive than L‑AMB costing €28,668 and €40,760 per patient, respectively. Because of lower simulated costs and the higher effectiveness of MICA (cost‑effectiveness [C/E] ratio = €54,215) compared with L‑AMB (C/E ratio = €83,035), MICA dominates L‑AMB. The results of the MC simulation and sensitivity analyses showed that MICA remained the most cost‑effective option. CONCLUSIONS:The lower costs and higher effectiveness predicted for MICA versus L‑AMB in this analysis indicate that in Italy, MICA is more cost‑effective for the treatment of SCIs when compared with L‑AMB.