OBJECTIVES: Comparing the cost-effectiveness of Micafungin (MICA) and Caspofungin (CASPO) for the treatment of systemic candida infections (SCIs) (including invasive candidiasis and candidaemia) in Germany. METHODS: A health economic decision model is based on a clinical study with a global population. The study was a Phase 3 double blind randomized controlled trial comparing MICA versus CASPO. Furthermore, German hospitalization and primary medication costs were included in the analysis. The model’s effectiveness outcome is defined as patients who are successfully treated and are alive. Cost-effectiveness is measured as total costs per patient with respect to effectiveness for each medication arm. In addition, sensitivity analyses were performed to identify cost-effectiveness for different clinical and economic assumptions. RESULTS: The analysis shows that 60% of MICA patients were successfully treated and survived at the end of study compared to 58% of CASPO patients. Furthermore, the costs of a MICA treatment (€37,212) are below the costs of a CASPO treatment (€37,720). Therefore, the cost-effectiveness ratio is lower for MICA (€62,377) than for CASPO (€65,565). This result also holds for all but one of the sensitivity analyses. However, probabilistic sensitivity and subgroup analyses show that differences cannot be considered statistically significant due to large variance. For European patients only, who can be assumed to be a more homogenous group and a better approximation of German patients, cost-effectiveness ratio for MICA is 59,406 € compared to €68,217 for CASPO, the difference being statistically significant. CONCLUSIONS: This study analyzes the cost-effectiveness of MICA as compared to CASPO for the treatment of systemic candida infections in Germany. Both lower costs and higher effectiveness of MICA render MICA as more cost-effective than CASPO.