Fluconazole versus oral polyenes in the prophylaxis of immunocompromised patients: a cost-minimization analysis

Wakerly, L.; Craig, Ann-Marie; Malek, Mo; Hoffmeyer, Ullrich; Lloyd, AC; Valette, F.; Phillips, Richard; Zabihollah, M

doi:10.1016/s0195-6701(96)90027-4

Cited by 9 publications

(16 citation statements)

References 15 publications

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“…year of publication, underlying disease, interventions and type of economic analysis) of the included economic studies. Of the 11 studies, three refer to the US, [34,36,37] two to Switzerland [28,38] and one each to the UK, [29] Germany, [31] the Netherlands, [35] Japan [30] and Korea, [33] and one to both the Netherlands and Germany. [32] The publication years ranged from 1995 to 2010, with the majority (9 of 11) being published after 2005.…”

Section: Literature Search Strategymentioning

confidence: 99%

“…A cost-benefit analysis was performed by Wakerly et al [29] to compare the cost implications of prophylactic treatment by means of fluconazole with oral polyenes, a combination of fluconazole and polyenes, and no prophylaxis. To assess the clinical outcomes and accompanying costs associated with the different prophylactic strategies, a decision tree was constructed.…”

Section: Description Of Selected Studiesmentioning

confidence: 99%

“…Data on treatment effectiveness, clinical outcomes and resource use were gathered through a literature survey and clinical interviews conducted in UK hospitals. Wakerly et al [29] concluded that all strategies involving prophylaxis are cheaper options than the 'no prophylaxis' strategy. The most favourable prophylactic strategy, however, depends on the patient group as well as the source (i.e.…”

Section: Description Of Selected Studiesmentioning

confidence: 99%

“…The cost benefit or cost effectiveness of antifungal prophylaxis with amphotericin B, fluconazole, itraconazole, micafungin and posaconazole have all been estimated. [28][29][30][31][32][33][34][35][36][37][38][39] Furthermore, a diversity of comparators were included in these economic analyses. The antifungals that have already been on the market for a considerable number of years now (i.e.…”

Section: Comparison Of Studiesmentioning

confidence: 99%

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Cost Benefit and Cost Effectiveness of Antifungal Prophylaxis in Immunocompromised Patients Treated for Haematological Malignancies

et al. 2011

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There has been a large increase in the incidence of invasive fungal infections (IFIs) over the past decades, largely because of the increasing size of the population at risk. One of the major risk groups for IFIs are patients with haematological malignancies treated with cytotoxic chemotherapy or undergoing haematopoietic stem cell transplantation. These IFIs are associated with high morbidity and mortality rates. Consequently, as the diagnosis of IFIs is difficult, antifungal prophylaxis is desirable in high-risk patients. Furthermore, as the economic impact of IFIs is also significant, it is important to assess the cost benefit and cost effectiveness of each prophylactic agent in order to aid decisions concerning which prophylactic agent provides the best value for limited healthcare resources. This article systematically reviews the available pharmacoeconomic evidence regarding antifungal prophylaxis in immunocompromised patients treated for haematological malignancies. Furthermore, specific points of interest concerning economic analyses of antifungal prophylaxis are briefly discussed. Considering the available evidence, antifungal prophylaxis in immunocompromised patients treated for haematological malignancies seems to be an intervention with favourable cost-benefit, cost-effectiveness and cost-saving potential. Furthermore, recently introduced antifungal agents seem to be attractive alternatives to fluconazole from a pharmacoeconomic point of view. However, due to wide heterogeneity in patient characteristics, underlying diseases, hospital settings and study methods in the included economic studies, as well as the lack of 'head-to-head' trials, it is difficult to find clear evidence of the economic advantages of a single prophylactic agent. Furthermore, we show that the results of cost-effectiveness analyses are highly dependent on several crucial factors that influence the baseline IFI incidence rates and, therefore, differ per patient population or region.

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Section: Literature Search Strategymentioning

confidence: 99%

Section: Description Of Selected Studiesmentioning

confidence: 99%

Section: Description Of Selected Studiesmentioning

confidence: 99%

Section: Comparison Of Studiesmentioning

confidence: 99%

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Cost Benefit and Cost Effectiveness of Antifungal Prophylaxis in Immunocompromised Patients Treated for Haematological Malignancies

et al. 2011

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“…Cost data for 1996 were extracted from the British National Formulary [19] and from a publication presenting unit costs for health care services used for prophylaxis against fungal infections in an immunocompromised population [20]. The expected cost and number of cases of CMV disease were calculated for each management strategy and then used to compute incremental cost-effectiveness ratios.…”

Section: Economics Of CMV Prophylaxis Versus Preemptive Therapymentioning

confidence: 99%

The Economic Value of Valacyclovir Prophylaxis in Transplantation

Squifflet

Legendre

2002

J INFECT DIS

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Cytomegalovirus (CMV) infection and disease, with its extensive direct and indirect consequences, adds considerably to the cost of patient management in both solid organ and bone marrow transplantation. Antiviral prophylaxis for CMV infection can offer cost advantages over preemptive therapy and "wait-and-treat" approaches. Valacyclovir has demonstrated efficacy for CMV prophylaxis in renal, heart, and bone marrow transplantation and is cost-effective when compared with placebo in renal transplant recipients at high risk of CMV infection. In reducing CMV infection and disease, valacyclovir prophylaxis appears to be associated with reductions in indirect effects of CMV (acute graft rejection, other opportunistic infections) and, if these effects are considered, the potential exists for even greater savings to be made with valacyclovir therapy. Benefits of valacyclovir in transplantation extend beyond CMV to other herpesviruses and may be increased in some clinical situations by prolonging prophylaxis beyond 3 months.

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Diagnosis and prevention of fungal infection in the immunocompromized patient

Richardson

Kokki

1998

Blood Reviews

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Fluconazole versus oral polyenes in the prophylaxis of immunocompromised patients: a cost-minimization analysis

Cited by 9 publications

References 15 publications

Cost Benefit and Cost Effectiveness of Antifungal Prophylaxis in Immunocompromised Patients Treated for Haematological Malignancies

Cost Benefit and Cost Effectiveness of Antifungal Prophylaxis in Immunocompromised Patients Treated for Haematological Malignancies

The Economic Value of Valacyclovir Prophylaxis in Transplantation

Diagnosis and prevention of fungal infection in the immunocompromized patient

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