Economic Evaluation of Voriconazole versus Caspofungin for the Treatment of Invasive Aspergillosis in Spain
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Clin Drug Invest 2007; 27 (3): 197-205 1173-2563/07/0003-0197/$44.95/0 © 2007 Adis Data Information BV. All rights reserved.
Economic Evaluation of Voriconazole versus Caspofungin for the Treatment of Invasive Aspergillosis in Spain Alfonso Dom´inguez-Gil,1 Isabel Mart´in,2 Mercedes Garc´ia Vargas,3 Almudena Del Castillo,4 Silvia D´iaz3 and Cristina S´anchez4 1 Servicio de Farmacia, Hospital Universitario de Salamanca, Salamanca, Spain ˜ Spain 2 Servicio de Farmacia, Hospital Juan Canalejo, La Coruna, 3 Medical Unit, Euroclin Institute, Madrid, Spain 4 Health Outcomes Research Department, Medical Unit, Pfizer Spain, Alcobendas, Spain
Abstract
Background and objective: Invasive fungal infections are becoming increasingly prevalent and are more frequently the aetiological agents responsible for nosocomial infections. Since mid-2002, two new antifungal drugs – voriconazole, a third-generation azole, and caspofungin, a member of a new class of drugs called echinocandins – have been marketed in Spain. Both drugs have proven efficacy in the treatment of aspergillosis, are better tolerated than amphotericin B and are cheaper than liposomal amphotericin B. The objective of this study was to conduct an economic evaluation of voriconazole versus caspofungin for the treatment of invasive aspergillosis in Spain. Methods: This was a cost-minimisation analysis (2006 costs) from the hospital perspective. Duration of treatment and bodyweight of patients were obtained from the Fungcost study and the incidence of adverse events was obtained from different published sources. Only direct costs were considered. Mean expected cost and incremental cost were calculated, and univariate and bivariate (bodyweight/treatment duration) sensitivity analyses were conducted. Results: The mean expected cost per episode was €6041.93 (intravenous treatment acquisition cost €5524.75) for voriconazole and €7174.05 (intravenous treatment acquisition cost €6672.80) for caspofungin in invasive aspergillosis; the incremental cost was €1132.18. Results were robust for any treatment duration and sensitive to bodyweights
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