Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain

Grau Cerrato, Santiago; Azanza Perea, José Ramon; Ruiz, Isabel; Vallejo, Carlos; Mensa, Josep; Maertens, Johan; Heinz, Werner; Barrueta, Jon Andoni; Peral, Carmen; Mesa, Francisco Jesús; Barrado, Miguel; Charbonneau, Claudie; Rubio-Rodríguez, Darío; Rubio-Terrés, Carlos

Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain

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dc.contributor.author Grau Cerrato, Santiagoca
dc.contributor.author Azanza Perea, José Ramonca
dc.contributor.author Ruiz, Isabelca
dc.contributor.author Vallejo, Carlosca
dc.contributor.author Mensa, Josepca
dc.contributor.author Maertens, Johanca
dc.contributor.author Heinz, Wernerca
dc.contributor.author Barrueta, Jon Andonica
dc.contributor.author Peral, Carmenca
dc.contributor.author Mesa, Francisco Jesúsca
dc.contributor.author Barrado, Miguelca
dc.contributor.author Charbonneau, Claudieca
dc.contributor.author Rubio-Rodríguez, Daríoca
dc.contributor.author Rubio-Terrés, Carlosca
dc.date.accessioned 2017-12-15T07:49:49Z
dc.date.available 2017-12-15T07:49:49Z
dc.date.issued 2016
dc.description.abstract OBJECTIVE: According to a recent randomized, double-blind clinical trial comparing the combination of voriconazole and anidulafungin (VOR+ANI) with VOR monotherapy for invasive aspergillosis (IA) in patients with hematologic disease or with hematopoietic stem cell transplant, mortality was lower after 6 weeks with VOR+ANI than with VOR monotherapy in a post hoc analysis of patients with galactomannan-based IA. The objective of this study was to compare the cost-effectiveness of VOR+ANI with VOR, from the perspective of hospitals in the Spanish National Health System. METHODS: An economic model with deterministic and probabilistic analyses was used to determine costs per life-year gained (LYG) for VOR+ANI versus VOR in patients with galactomannan-based IA. Mortality, adverse event rates, and life expectancy were obtained from clinical trial data. The costs (in 2015 euros [€]) of the drugs and the adverse event-related costs were obtained from Spanish sources. A Tornado plot and a Monte Carlo simulation (1,000 iterations) were used to assess uncertainty of all model variables. RESULTS: According to the deterministic analysis, for each patient treated with VOR+ANI compared with VOR monotherapy, there would be a total of 0.348 LYG (2.529 vs 2.181 years, respectively) at an incremental cost of €5,493 (€17,902 vs €12,409, respectively). Consequently, the additional cost per LYG with VOR+ANI compared with VOR would be €15,785. Deterministic sensitivity analyses confirmed the robustness of these findings. In the probabilistic analysis, the cost per LYG with VOR+ANI was €15,774 (95% confidence interval: €15,763-16,692). The probability of VOR+ANI being cost-effective compared with VOR was estimated at 82.5% and 91.9%, based on local cost-effectiveness thresholds of €30,000 and €45,000, respectively. CONCLUSION: According to the present economic study, combination therapy with VOR+ANI is cost-effective as primary therapy of IA in galactomannan-positive patients in Spain who have hematologic disease or hematopoietic stem cell transplant, compared with VOR monotherapy.
dc.format.mimetype application/pdfca
dc.identifier.citation Grau S, Azanza JR, Ruiz I, Vallejo C, Mensa J, Maertens J. et al. Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain. Clinicoecon Outcomes Res. 2016 Dec 30;9:39-47. DOI: 10.2147/CEOR.S122177
dc.identifier.doi http://dx.doi.org/ 10.2147/CEOR.S122177
dc.identifier.issn 1178-6981
dc.identifier.uri http://hdl.handle.net/10230/33499
dc.language.iso eng
dc.publisher Dove Medical Pressca
dc.relation.ispartof ClinicoEconomics and Outcomes Research. 2016 Dec 30;9:39-47
dc.rights © 2017 Grau et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.subject.keyword Anidulafungin
dc.subject.keyword Cost-effectiveness
dc.subject.keyword Galactomannan
dc.subject.keyword Invasive aspergillosis
dc.subject.keyword Voriconazole
dc.subject.other Hematologia -- Malalties
dc.title Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spainca
dc.type info:eu-repo/semantics/article
dc.type.version info:eu-repo/semantics/publishedVersion

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