Cost-effectiveness analysis of micafungin versus caspofungin for treatment of systemic <i>Candida</i> infections in the UK

Sidhu, M.; Engen, Anke K. Van; Kleintjens, J.; Schoeman, O.; Palazzo, M. G. A.

doi:10.1185/03007990903072565

Cited by 26 publications

(24 citation statements)

References 14 publications

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“…Costs generally ranged from €8,351 to €11,821 when evaluating incremental hospitalisation and antifungal drug expenditure only, €3,930–€7,314 for antifungal drugs, €8,252–€51,760 for hospital bed day costs and €26,596–€83,300 when all direct costs for management were included [35–37, 58, 59, 61, 67, 68, 77, 86]. …”

Section: Resultsmentioning

confidence: 99%

Clinical and economic burden of invasive fungal diseases in Europe: focus on pre-emptive and empirical treatment of Aspergillus and Candida species

Drgoňa

Khachatryan

Stephens

et al. 2013

Eur J Clin Microbiol Infect Dis

110

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Invasive fungal diseases (IFDs) have been widely studied in recent years, largely because of the increasing population at risk. Aspergillus and Candida species remain the most common causes of IFDs, but other fungi are emerging. The early and accurate diagnosis of IFD is critical to outcome and the optimisation of treatment. Rapid diagnostic methods and new antifungal therapies have advanced disease management in recent years. Strategies for the prevention and treatment of IFDs include prophylaxis, and empirical and pre-emptive therapy. Here, we review the available primary literature on the clinical and economic burden of IFDs in Europe from 2000 to early 2011, with a focus on the value and outcomes of different approaches.Electronic supplementary materialThe online version of this article (doi:10.1007/s10096-013-1944-3) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Clinical and economic burden of invasive fungal diseases in Europe: focus on pre-emptive and empirical treatment of Aspergillus and Candida species

Drgoňa

Khachatryan

Stephens

et al. 2013

Eur J Clin Microbiol Infect Dis

110

View full text Add to dashboard Cite

show abstract

“…Two articles were excluded because they involved patients with invasive aspergillosis. Two articles evaluated the cost-effectiveness of caspofungin in candidemia [23,24]. Wingard et al described favourable effects of using caspofungin instead of LAmB.…”

Section: Resultsmentioning

confidence: 99%

“…Two articles evaluated the use of micafungin in candidemia or invasive candidiasis [24,27]. Cornely et al assessed the economic impact of using micafungin vs. LAmB in candidemia and invasive candidiasis.…”

Section: Resultsmentioning

confidence: 99%

Treatment and prophylaxis of invasive candidiasis with anidulafungin, caspofungin and micafungin and its impact on use and costs - review of the literature

Wilke¹

2011

Eur J Med Res

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Invasive fungal infections are on the rise. Echinocandins are a relatively new class of antifungal drugs that act by inhibition of a key enzyme necessary for integrity of the fungal cell wall. Currently there are three available agents: caspofungin, micafungin and anidulafungin.While the individual echinocandin antifungals have a different spectrum of licensed indications, basically all of them are available for the treatment of candidemia and invasive candidiasis. Antifungal treatment modalities basically include in therapy for suspected or proven infection and prophylaxis. All three drugs are comparatively expensive. Therefore a systematic review of the literature was performed to investigate the following aspects:• General aspects of cost-effectiveness in the treatment of invasive fungal infections• Cost-effectiveness of the treatment with the above-mentioned antifungals• Cost-effectiveness in two settings: therapy and prophylaxisEarly initiation of antifungal therapy, adjustment after availability of microbiological results, duration of therapy, success and occurrence of severe complications (e.g renal failure) are the most important cost drivers in antifungal therapy.Considering the specific antifungals, for caspofungin the best evidence for cost-effectiveness is found in treatment of invasive candidiasis and in empiric therapy of suspected infections. Favourable economic data are available for micafungin as a cost-effective alternative to LAmB for prophylaxis in patients with hematopoietic stem cell transplantation (HSCT). For anidulafungin, cost-effectiveness was demostrated in a pharmacoeconomic model. Net savings - yet not significant - were observed in a retrospective chart review of 234 patients. Generally, however, most analyses are still based on pharmacoeconomic modelling rather than direct analysis of trial data or real-life clinical populations.As an overall conclusion, using caspofungin, micafungin, or anidulafungin is not more expensive than using other established therapies. Micafungin has proven to be cost-effective in prophylaxis if the local fungal epidemiology indicates a high level of resistance to fluconazole. Switch strategies involving early initiation of broadly active therapy with switch to cheaper alternatives according to microbiology results and clinical status and early initiation of an appropriate therapy have been proven to be cost-efficient independent of the antifungal agent.

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“…Other inputs were all-cause 6-week mortality, cost of treatment-related adverse events (AEs) and other medical resource use costs. Life-years were calculated using a published model [4]. Antifungal agent-related AEs were taken from the product label/literature.…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness analysis of anidulafungin in the treatment of candidaemia

et al. 2013

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Cost-effectiveness analysis of micafungin versus caspofungin for treatment of systemic Candida infections in the UK

Abstract: Costs and effects of micafungin compare to those of caspofungin in the treatment of systemic Candida infections in the UK. The results indicate that micafungin is cost-effective compared to caspofungin, although the difference was not found to be significant.

Cited by 26 publications

References 14 publications

Clinical and economic burden of invasive fungal diseases in Europe: focus on pre-emptive and empirical treatment of Aspergillus and Candida species

Clinical and economic burden of invasive fungal diseases in Europe: focus on pre-emptive and empirical treatment of Aspergillus and Candida species

Treatment and prophylaxis of invasive candidiasis with anidulafungin, caspofungin and micafungin and its impact on use and costs - review of the literature

Cost-effectiveness analysis of anidulafungin in the treatment of candidaemia

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