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

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...

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Autores: Grau, Santiago|||0000-0002-8428-1836, Azanza Perea, José Ramón|||0000-0003-3190-622X, Ruiz-Camps, Isabel|||0000-0003-3743-2379, Vallejo, Carlos, Mensa, Josep, Maertens, Johan|||0000-0003-4257-5980, Heinz, Werner J., Barrueta, Jon Andoni, Peral, Carmen, Mesa, Francisco Jesús, Barrado, Miguel, Charbonneau, Claudie, Rubio-Rodríguez, Darío, Rubio-Terrés, Carlos
Tipo de recurso: artículo
Fecha de publicación:2016
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:186132
Acceso en línea:https://ddd.uab.cat/record/186132
https://dx.doi.org/urn:doi:10.2147/CEOR.S122177
Access Level:acceso abierto
Palabra clave:Anidulafungin
Cost-effectiveness
Galactomannan
Invasive aspergillosis
Voriconazole
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spelling Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in SpainGrau, Santiago|||0000-0002-8428-1836Azanza Perea, José Ramón|||0000-0003-3190-622XRuiz-Camps, Isabel|||0000-0003-3743-2379Vallejo, CarlosMensa, JosepMaertens, Johan|||0000-0003-4257-5980Heinz, Werner J.Barrueta, Jon AndoniPeral, CarmenMesa, Francisco JesúsBarrado, MiguelCharbonneau, ClaudieRubio-Rodríguez, DaríoRubio-Terrés, CarlosAnidulafunginCost-effectivenessGalactomannanInvasive aspergillosisVoriconazoleAccording 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. 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. 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. 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.Universitat Autònoma de Barcelona 22016-01-0120162016-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/186132https://dx.doi.org/urn:doi:10.2147/CEOR.S122177reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:1861322026-06-06T12:50:31Z
dc.title.none.fl_str_mv Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain
title Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain
spellingShingle Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain
Grau, Santiago|||0000-0002-8428-1836
Anidulafungin
Cost-effectiveness
Galactomannan
Invasive aspergillosis
Voriconazole
title_short Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain
title_full Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain
title_fullStr Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain
title_full_unstemmed Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain
title_sort Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain
dc.creator.none.fl_str_mv Grau, Santiago|||0000-0002-8428-1836
Azanza Perea, José Ramón|||0000-0003-3190-622X
Ruiz-Camps, Isabel|||0000-0003-3743-2379
Vallejo, Carlos
Mensa, Josep
Maertens, Johan|||0000-0003-4257-5980
Heinz, Werner J.
Barrueta, Jon Andoni
Peral, Carmen
Mesa, Francisco Jesús
Barrado, Miguel
Charbonneau, Claudie
Rubio-Rodríguez, Darío
Rubio-Terrés, Carlos
author Grau, Santiago|||0000-0002-8428-1836
author_facet Grau, Santiago|||0000-0002-8428-1836
Azanza Perea, José Ramón|||0000-0003-3190-622X
Ruiz-Camps, Isabel|||0000-0003-3743-2379
Vallejo, Carlos
Mensa, Josep
Maertens, Johan|||0000-0003-4257-5980
Heinz, Werner J.
Barrueta, Jon Andoni
Peral, Carmen
Mesa, Francisco Jesús
Barrado, Miguel
Charbonneau, Claudie
Rubio-Rodríguez, Darío
Rubio-Terrés, Carlos
author_role author
author2 Azanza Perea, José Ramón|||0000-0003-3190-622X
Ruiz-Camps, Isabel|||0000-0003-3743-2379
Vallejo, Carlos
Mensa, Josep
Maertens, Johan|||0000-0003-4257-5980
Heinz, Werner J.
Barrueta, Jon Andoni
Peral, Carmen
Mesa, Francisco Jesús
Barrado, Miguel
Charbonneau, Claudie
Rubio-Rodríguez, Darío
Rubio-Terrés, Carlos
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Anidulafungin
Cost-effectiveness
Galactomannan
Invasive aspergillosis
Voriconazole
topic Anidulafungin
Cost-effectiveness
Galactomannan
Invasive aspergillosis
Voriconazole
description 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. 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. 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. 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.
publishDate 2016
dc.date.none.fl_str_mv 2
2016-01-01
2016
2016-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/186132
https://dx.doi.org/urn:doi:10.2147/CEOR.S122177
url https://ddd.uab.cat/record/186132
https://dx.doi.org/urn:doi:10.2147/CEOR.S122177
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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