Isavuconazole cost effective for invasive fungal infections
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Isavuconazole cost effective for invasive fungal infections The cost effectiveness of isavuconazole in patients with invasive fungal infections was assessed in two studies presented at the 23rd Annual European Congress of the International Society for Pharmacoeconomics and Outcomes Research in November 2020, which was held as a virtual conference (Virtual ISPOR Europe 2020).
Cost effective in Canada . . . Isavuconazole was recently approved in Canada for the treatment of both invasive aspergillosis (IA) and invasive mucormycoses. In an AVIR-Pharma-funded study presented at ISPOR, isavuconazole was found to be cost effective compared with voriconazole in patients with suspected pulmonary invasive mycoses in Canada.1 A decision-tree model populated with data from the randomised SECURE and VITAL trials was used to evaluate the cost effectivness of isavuconazole versus voriconazole, from Canadian Ministry of Health (MoH) and societal perspectives over a 5-year time horizon. Isavuconazole was associated with an incremental gain of 0.146 QALYs compared with voriconazole in patients with suspected invasive fungal infections, at an estimated incremental cost of $4391 [Canadian dollars] from the MoH perspective, resulting in an incremental cost-effectiveness ratio (ICER) of $30 160 per QALY gained. Findings were similar from the societal perspective. In probability sensitivity analysis, isavuconazole was found to be cost effective in 62% of simulations from the MoH perspective, at a willingness-to-pay threshold of $50 000 per QALY gained.
. . . and Portugal Isavuconazole was also found to be cost effective compared with generic voriconazole in patients with suspected pulmonary invasive mycoses in Portugal, in a Pfizer-funded study presented at ISPOR.2 Another decision-analytical model populated with data from the SECURE and VITAL trials was used to assess the cost effectivness of isavuconazole compared with voriconazole in patients with suspected invasive fungal infections, from a Portuguese National Health Service perspective over a lifetime time horizon. It was assumed that patients who initiated voriconazole for suspected IA switched to liposomal amphotericin-B if mucormycosis was diagnosed. The estimated total cost per patient was higher with isavuconazole than with generic voriconazole (€19 606 vs €16 198) but the estimated incremental QALY gain was greater (0.32 QALYs), resulting in an ICER of €10 668 per QALY gained. In scenario analysis, isavuconazole was dominant (more effective and less costly) compared with voriconazole in patients with renal impairment, with an incremental gain of 0.39 QALYs at a cost saving of €5751. "Isavuconazole is a cost-effective treatment when compared to generic voriconazole in patients with possible IA at usually accepted thresholds, and a dominant option in the subpopulation of patients with renal impairment," concluded the authors. 1. Beauchemin C, et al. Isavuconazole for the Treatment of Invasive Aspergillosis and Mucormycosis- A Canadian Cost-Utility Analysis. 23rd Annual Euro
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