Background: Candidemia and other invasive Candida infections are economically costly and can cause patient death. Anidulafungin, a newly licensed candin, has shown to be effective in treating candidemia. The aim of the study is to evaluate the cost-effectiveness of anidulafungin compared with current standard of care, fluconazole, for the treatment of invasive candidiasis and candidemia in Spain. Methods: A decision tree model from the hospital perspective was constructed to examine the cost-effectiveness of anidulafungin compared with fluconazole in the treatment of confirmed candidemia. Treatment success, patient treatment patterns, and patient survival were based on the results from a randomized, double-blind multicenter trial (Reboli AC, et al. N Engl J Med. 2007). Only in-hospital (â‚¬2007) direct costs per-patient were considered. Costs were obtained from a Spanish national database. Renal toxicity probabilities and costs were extracted from the published literature. The incremental cost per successfully treated patient was calculated. One-way sensitivity analyses were performed to test the robustness of the model. Results: The percentage of successfully treated patients at the end of all therapy was higher for patients treated with anidulafungin than with fluconazole (74% vs. 57%). Treating with anidulafungin resulted in a higher antifungal drug costs (5.780â‚¬ vs. 2.082â‚¬); however, overall costs are lower for treatment with anidulafungin than for treatment with fluconazole (37.240â‚¬ vs. 37.327â‚¬) due to an offset in other medical costs. Univariate sensitivity analyses showed that anidulafungin remained the most cost-effective option. Conclusions: Anidulafungin has demonstrated to improve the clinical efficacy versus standard of care in treating confirmed candidemia. Despite an increase in drug costs, treating confirmed candidemia with anidulafungin is a cost-effective strategy.
Full conference title:
19th European Congress of Clinical Microbiology and Infectious Diseases
- ECCMID 19th (2009)