NDLI: Cost-effectiveness analysis of antifungal prophylaxis in patients undergoing hematopoietic stem cell transplantation.

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Cost-effectiveness analysis of antifungal prophylaxis in patients undergoing hematopoietic stem cell transplantation.

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Cost-effectiveness analysis of antifungal prophylaxis in patients undergoing hematopoietic stem cell transplantation.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Schonfeld, Warren Wang Cheng, J. Tong, Kuo B. Seifeldin, Raafat
Description	Country affiliation: United States Author Affiliation: Schonfeld W ( Quorum Consulting, Inc., 222 Kearny Street, 10th Floor, San Francisco, CA 94108, USA.)
Abstract	BACKGROUND: Micafungin sodium is indicated for the prophylaxis of Candida infections in patients undergoing hematopoietic stem cell transplantation (HSCT). One Phase III, multi-institutional, randomized, doubleblind comparative trial involving 882 adult and pediatric patients found that micafungin was more effective, in terms of significantly lower rates of systemic fungal infections and empiric antifungal therapy (AFT), than fluconazole as antifungal prophylaxis during the neutropenic phase following HSCT. Thus, despite the higher cost of micafungin versus fluconazole, micafungin prophylaxis may be associated with reduced costs. OBJECTIVE: The aim of this analysis was to determine the cost-effectiveness of micafungin prophylaxis compared with fluconazole prophylaxis in patients undergoing HSCT. METHODS: Efficacy data were taken from the clinical study. The economic analysis was conducted from the hospital perspective, using costs incurred from admission through discharge. Each of the patients was assigned costs and effectiveness based on outcomes data from the clinical study. Published literature was used to estimate hospital costs associated with HSCT and prophylaxis, empiric AFT, and treatment of a probable or proven Candida or Aspergillus infection. Mean costs and effectiveness were calculated in each treatment group. To test the variability of the results using repeated sampling, a bootstrapping analysis was also conducted, with 1,000 simulations of random samples of 100 patients from each treatment group. If appropriate to describe the results, incremental cost effectiveness ratios were calculated, and sensitivity analyses were conducted by varying components of cost. RESULTS: This analysis included data from 882 patients (527 males, 355 females; micafungin, 425 patients, mean age, 43.2 years [range, 0.6-73.0 years]; fluconazole, 457 patients, mean age, 41.9 years [range, 0.6-71.0 years]). Total hospital costs per patient were USD121,098 and USD124,957 in micafungin and fluconazole recipients, respectively-a difference of USD3,859. The bootstrapping analysis found that micafungin prophylaxis was cost-saving in 72.4% of the samples compared with 9.2% with fluconazole prophylaxis. Sensitivity analyses on estimated hospital costs found that micafungin was a cost-effective therapy. CONCLUSION: In this analysis of data from a clinical study in adults and children undergoing HSCT, micafungin prophylaxis was associated with reduced hospital costs, and resultant total patient costs, compared with fluconazole prophylaxis.
File Format	HTM / HTML
ISSN	01492918
Issue Number	5
Volume Number	30
e-ISSN	1879114X
Journal	Clinical Therapeutics
Language	English
Publisher	Elsevier
Publisher Date	2008-05-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pharmacology Antifungal Agents Economics Echinocandins Fluconazole Hematopoietic Stem Cell Transplantation Lipoproteins Mycoses Prevention & Control Adolescent Adult Aged Therapeutic Use Chemoprevention Child Child, Preschool Cost-benefit Analysis Female Humans Infant Lipopeptides Male Middle Aged Comparative Study Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Pharmacology Pharmacology (medical)

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Cost-effectiveness analysis of micafungin versus fluconazole for prophylaxis of invasive fungal infections in patients undergoing hematopoietic stem cell transplantation in Korea.

Micafungin versus fluconazole for prophylaxis against invasive fungal infections during neutropenia in patients undergoing hematopoietic stem cell transplantation.

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Cost-effectiveness analysis of antifungal prophylaxis in patients undergoing hematopoietic stem cell transplantation.

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Posaconazole plasma concentration in pediatric patients receiving antifungal prophylaxis after allogeneic hematopoietic stem cell transplantation.

Micafungin versus fluconazole for prophylaxis against fungal infections in premature infants.

Caspofungin: in pediatric patients with fungal infections.

Cost-effectiveness analysis of antifungal prophylaxis in patients undergoing hematopoietic stem cell transplantation.

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