COST-EFFECTIVENESS ANALYSIS OF ANIDULAFUNGIN FOR THE MANAGEMENT OF INVASIVE CANDIDIASIS IN NON-NEUTROPENIC PATIENTS IN MEXICO
Author(s)
Jf Mould-Quevedo, PhD, MSc, MBA, Pharmacoeconomics Manager1, Iris Contreras-Hernandez, MSc, MD, Health Economics Researcher2, Gabriela Y Vega-Hernández, Bcs, Outcomes Research Coordinator1, Gabriela Davila-Loaiza, MD, Clinical Research Director11Pfizer Mexico, Mexico City, Mexico; 2 Social Security Mexican Institute, Mexico City, Mexico
Objective: Invasive candidiasis is a serious infectious disease with high incidence and important economic impact due to its long hospitalizations. The purpose of this study was to estimate the cost-effectiveness of anidulafungin and other antifungal agents in the management of invasive candidiasis in non-neutropenic patients from the payer's perspective. Methods: A Bayesian decision tree model allowing switches among different antifungal treatments was performed. The model simulates costs and effectiveness in a 12-week-period. Effectiveness measures were the rate of clinical success and percentage of survival. Clinical efficacy and transition probabilities were obtained from published literature. Comparators were anidulafungin (100mg/day), amphotericin B (0.6mg/kg/day) and fluconazol (initial dose 400mg/day, subsequent 200mg/day). Resource use data and costs were obtained from a tertiary care hospital “Hospital de Especialidades” CMN Siglo XXI from the Social Security Mexican Institute (n=25). Resource use include: inpatient services, intensive care unit, drugs and surgery. One-way sensitivity analysis was performed and other probabilistic sensitivity analyses were constructed. Results: Patients treated with anidulafungin experienced the higher clinical success (74.02%) followed by amphotericin B (63.51%) and fluconazol (56.78%). On the other hand, anidulafungin yielded 77.17% of total-survival followed by fluconazol with 68.64% and amphotericin B with 62.19%. The mean total costs per patient were US$47,993 for anidulafungin; US$59,350 for fluconazol and US$60,349 for amphotericin B. ICERs estimated using amphotericin B as the baseline strategy using clinical success as effectiveness outcome were -US$117,633 for anidulafungin and US$14,847 for fluconazol. ICER's estimated using the same comparator for total-survival as effectiveness was -US$82,503 for anidulafungin and -US$15,482 for fluconazol. Sensitivity analyses showed that anidulafungin was the dominant strategy (p<0.05). Conclusion: In Mexico, anidulafungin treatment was a cost-saving therapy not only because of its higher clinical success and survival but for its potential cost reduction. These results should be considered by Mexican decision-makers in future cost-containment policies.
Conference/Value in Health Info
2008-05, ISPOR 2008, Toronto, Ontario, Canada
Value in Health, Vol. 11, No. 3 (May/June 2008)
Code
PIN24
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Infectious Disease (non-vaccine)