Wingard John R, Leather Helen L, Wood Craig A, Gerth William C, Lupinacci Robert J, Berger Marc L, Mansley Edward C
Division of Hematology and Oncology, College of Medicine, University of Florida Shands Cancer Center, Gainesville, Florida 32610-0277, USA.
Am J Health Syst Pharm. 2007 Mar 15;64(6):637-43. doi: 10.2146/ajhp050521.
An analysis was conducted that evaluated and compared the cost differences between caspofungin and liposomal amphotericin B when the medications were used as empirical antifungal therapy for persistent fever during neutropenia.
Rates of drug use and impaired renal function (IRF) were based on data from published studies. IRF was defined as a doubling of the serum creatinine level or, if the creatinine level was elevated at enrollment, an increase of at least 1 mg/dL. The estimates of the costs for drug acquisition and treating IRF were derived using published data and applied to compare caspofungin with liposomal amphotericin B. Sensitivity analyses were performed by varying the IRF and relative acquisition costs to assess the effect of these factors on the cost differences.
The acquisition costs per patient were 6942 dollars for liposomal amphotericin B and 3996 dollars for caspofungin. The estimated cost per patient from IRF was 3173 dollars for liposomal amphotericin B and 793 dollars for caspofungin. Combining drug acquisition and IRF costs, the overall treatment cost per patient for caspofungin was 5326 dollars less than for liposomal amphotericin B. In sensitivity analyses of drug costs, the price of liposomal amphotericin B would have to be 23.95 dollars per vial for the overall treatment costs to be equal.
Comparison of cost estimates derived from published data revealed that a combined estimate of acquisition costs and costs related to the treatment of IRF was lower for caspofungin than for liposomal amphotericin B for empirically treating patients with neutropenic fever.
进行了一项分析，评估并比较了卡泊芬净和两性霉素B脂质体在作为中性粒细胞减少期间持续发热的经验性抗真菌治疗药物时的成本差异。
药物使用和肾功能损害（IRF）发生率基于已发表研究的数据。IRF定义为血清肌酐水平加倍，或者如果肌酐水平在入组时升高，则至少增加1mg/dL。使用已发表数据得出药物采购和治疗IRF的成本估算，并用于比较卡泊芬净和两性霉素B脂质体。通过改变IRF和相对采购成本进行敏感性分析，以评估这些因素对成本差异的影响。
两性霉素B脂质体每位患者的采购成本为6942美元，卡泊芬净为3996美元。两性霉素B脂质体每位患者IRF的估计成本为3173美元，卡泊芬净为793美元。将药物采购成本和IRF成本相结合，卡泊芬净每位患者的总体治疗成本比两性霉素B脂质体低5326美元。在药物成本敏感性分析中，两性霉素B脂质体每瓶价格必须为23.95美元，总体治疗成本才会相等。
对已发表数据得出的成本估算进行比较发现，对于中性粒细胞减少性发热患者的经验性治疗，卡泊芬净的采购成本与IRF治疗相关成本的综合估算低于两性霉素B脂质体。
