PMID- 25253630
OWN - NLM
STAT- MEDLINE
DCOM- 20150331
LR  - 20211021
IS  - 2050-6511 (Electronic)
IS  - 2050-6511 (Linking)
VI  - 15
DP  - 2014 Sep 24
TI  - Cost analysis of voriconazole versus liposomal amphotericin B for primary therapy 
      of invasive aspergillosis among patients with haematological disorders in Germany 
      and Spain.
PG  - 52
LID - 10.1186/2050-6511-15-52 [doi]
AB  - BACKGROUND: The current healthcare climate demands pharmacoeconomic evaluations 
      for different treatment strategies incorporating drug acquisition costs, costs 
      incurred for hospitalisation, drug administration and preparation, diagnostic and 
      laboratory testing and drug-related adverse events (AEs). Here we evaluate the 
      pharmacoeconomics of voriconazole versus liposomal amphotericin B as first-line 
      therapies for invasive aspergillosis (IA) in patients with haematological 
      malignancy and prolonged neutropenia or who were undergoing haematopoietic 
      stem-cell transplantation in Germany or Spain. METHODS: A decision analytic model 
      based on a decision tree was constructed to estimate the potential treatment 
      costs of voriconazole versus liposomal amphotericin B. Each model pathway was 
      defined by the probability of an event occurring and the costs of clinical 
      outcomes. Outcome probabilities and cost inputs were derived from the published 
      literature, clinical trials, expert panels and local database costs. In the base 
      case, patients who failed to respond to first-line therapy were assumed to 
      experience a single switch between comparator drugs or the other drug was added 
      as second-line treatment. Base-case evaluation included only drug-management 
      costs and additional hospitalisation costs due to severe AEs associated with 
      first- and second-line therapies. Sensitivity analyses were conducted to assess 
      the robustness of the results. Cost estimates were inflated to 2011 euros (euro). 
      RESULTS: Based on clinical trial success rates of 52.8% (voriconazole) and 50.0% 
      (liposomal amphotericin B), voriconazole had lower total treatment costs compared 
      with liposomal amphotericin B in both Germany (euro 12,256 versus euro 18,133; length 
      of therapy [LOT] = 10-day intravenous [IV] + 5-day oral voriconazole and 15-day 
      IV liposomal amphotericin B) and Spain (euro 8,032 versus euro 10,516; LOT = 7-day 
      IV + 8-day oral voriconazole and 15-day IV liposomal amphotericin B). Assuming 
      the same efficacy (50.0%) in first-line therapy, voriconazole maintained a lower 
      total treatment cost compared with liposomal amphotericin B. Cost savings were 
      primarily due to the lower drug acquisition costs and shorter IV LOT associated 
      with voriconazole. Sensitivity analyses showed that the results were sensitive to 
      drug price, particularly the cost of liposomal amphotericin B. CONCLUSIONS: 
      Voriconazole is likely to be cost-saving compared with liposomal amphotericin B 
      when used as a first-line treatment for IA in Germany and Spain.
FAU - Ostermann, Helmut
AU  - Ostermann H
FAU - Solano, Carlos
AU  - Solano C
FAU - Jarque, Isidro
AU  - Jarque I
FAU - Garcia-Vidal, Carolina
AU  - Garcia-Vidal C
FAU - Gao, Xin
AU  - Gao X
FAU - Barrueta, Jon Andoni
AU  - Barrueta JA
FAU - De Salas-Cansado, Marina
AU  - De Salas-Cansado M
FAU - Stephens, Jennifer
AU  - Stephens J
AD  - Pharmerit International, Bethesda, MD, USA. jstephens@pharmerit.com.
FAU - Xue, Mei
AU  - Xue M
FAU - Weber, Bertram
AU  - Weber B
FAU - Charbonneau, Claudie
AU  - Charbonneau C
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140924
PL  - England
TA  - BMC Pharmacol Toxicol
JT  - BMC pharmacology & toxicology
JID - 101590449
RN  - 0 (Antifungal Agents)
RN  - 7XU7A7DROE (Amphotericin B)
RN  - JFU09I87TR (Voriconazole)
SB  - IM
MH  - Amphotericin B/*economics/therapeutic use
MH  - Antifungal Agents/*therapeutic use
MH  - Aspergillosis/complications/*drug therapy
MH  - *Costs and Cost Analysis
MH  - Germany
MH  - Hematologic Diseases/*complications
MH  - Spain
MH  - Voriconazole/*economics/therapeutic use
PMC - PMC4183350
EDAT- 2014/09/26 06:00
MHDA- 2015/04/01 06:00
PMCR- 2014/09/24
CRDT- 2014/09/26 06:00
PHST- 2014/04/02 00:00 [received]
PHST- 2014/09/16 00:00 [accepted]
PHST- 2014/09/26 06:00 [entrez]
PHST- 2014/09/26 06:00 [pubmed]
PHST- 2015/04/01 06:00 [medline]
PHST- 2014/09/24 00:00 [pmc-release]
AID - 2050-6511-15-52 [pii]
AID - 10.1186/2050-6511-15-52 [doi]
PST - epublish
SO  - BMC Pharmacol Toxicol. 2014 Sep 24;15:52. doi: 10.1186/2050-6511-15-52.