Premium
Economic evaluation of micafungin vs. Liposomal Amphotericin B (LAmB) for the treatment of candidaemia and Invasive Candidiasis (IC)
Author(s) -
Neoh Chin Fen,
Liew Danny,
Slavin Monica A.,
Marriott Debbie,
Chen Sharon C.A.,
Morrissey Orla,
Stewart Kay,
Kong David C. M.
Publication year - 2013
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.12071
Subject(s) - micafungin , medicine , invasive candidiasis , intensive care medicine , antifungal , amphotericin b , fluconazole , dermatology
Summary Micafungin was non‐inferior to liposomal amphotericin B ( LA mB) for the treatment of candidaemia and invasive candidiasis ( IC ) in a major clinical trial. The present study investigated the economic impact of micafungin vs. LA mB in treating candidaemia and IC . A decision analytical model was constructed to capture downstream consequences of using micafungin or LA mB as primary definitive therapy. The main outcomes were treatment success and treatment failure due to mycological persistence, or death. Outcome probabilities were derived from key published sources. Resource used was estimated by an expert panel and cost inputs were from the latest Australian resources. The analysis was from an Australian hospital perspective. Sensitivity analyses using Monte Carlo simulation were conducted. Micafungin ( AU $61 426) had a lower total cost than LA mB ( AU $72 382), with a total net cost‐saving of AU $10 957 per patient. This was primarily due to the lower cost associated with initial antifungal treatment and shorter length of stay for patients in the micafungin arm. Hospitalisation was the main cost driver for both arms. Results were robust over a wide range of variables. The uncertainty analysis demonstrated that micafungin had a 99.9% chance of being cost‐saving compared with LA mB. Micafungin was associated with cost‐saving relative to LA mB in the treatment of candidaemia and IC in Australia.