Premium
Cost effectiveness of caspofungin vs. voriconazole for empiric therapy in Turkey
Author(s) -
Turner S. J.,
Senol E.,
Kara A.,
AlBadriyeh D.,
Dinleyici E. C.,
Kong D. C. M.
Publication year - 2014
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.12187
Subject(s) - caspofungin , voriconazole , pharmacoeconomics , medicine , formulary , intensive care medicine , neutropenia , empiric therapy , cost effectiveness , febrile neutropenia , antifungal , chemotherapy , pharmacology , risk analysis (engineering) , alternative medicine , dermatology , pathology
Summary Invasive fungal infections from febrile neutropenia are associated with significant cost and mortality. The mainstay of treatment has been liposomal amphotericin B, however, echinocandins and azoles have shown promise as alternative treatments. Data on clinical efficacy exist, however, data incorporating pharmacoeconomic considerations are required in Turkey. The aim of this study was to investigate the cost effectiveness of caspofungin vs. voriconazole in empiric treatment of febrile neutropenia in Turkey. A decision analytic model was utilised, built upon two randomised‐controlled trials and supplemented with expert panel input from clinicians in Turkey. A five‐point composite outcome measure was utilised and sensitivity analyses were performed to demonstrate the robustness of the model. The base case scenario resulted in caspofungin being preferred by TL 2,533, TL 29,256 and TL 2,536 per patient treated, successfully treated patient and patient survival, respectively (approx. USD 1414, 16 328 and 1415); sensitivity analyses did not change the outcome. Monte Carlo simulation highlighted a 78.8% chance of favouring caspofungin. The result was moderately sensitive to treatment duration and acquisition cost of the antifungal agents compared. This is the first pharmacoeconomic study comparing caspofungin to voriconazole within Turkey, resulting in an advantage towards caspofungin. The study will aid in formulary decision‐making based on the clinical and economic consequences of each agent in the Turkish health care setting.