Lecointre R, Bleyzac N
Institut d'oncologie et d'hématologie pédiatrie (IHOP), hospice civil de Lyon, France.
Ann Pharm Fr. 2011 Jul;69(4):214-20. doi: 10.1016/j.pharma.2011.05.001. Epub 2011 Jul 27.
Invasive fungal infections are an important cause of mortality in oncology and haematology unit care. Immunosuppression allows the occurrence of Candida or Aspergillus infectious disease. Treatment is based on antifungal agents (liposomal amphotericin B, azoles and caspofungin) administrated alone. The lack of study does not yet validate the combination of two drugs which are not recommended in medical practice. The aim of this pharmacoeconomics study is to assess different therapeutic strategies compared to standard treatment. Health care system point of view is used. Results show that liposomal amphotericin B is the reference standard drug during no documented infection in term of cost. But, voriconazole does not have significative cost variation for Aspergillus disease. Same conclusion can be showed, in case of candidosis for caspofungin. The sensitivity analysis shows that daily cost treatment and body weight are variables with important impact on results. This preliminary analysis must be continued by a clinical study in order to assess different antifungal treatments.
侵袭性真菌感染是肿瘤学和血液学病房护理中导致死亡的重要原因。免疫抑制会引发念珠菌或曲霉菌感染性疾病。治疗基于单独使用的抗真菌药物（脂质体两性霉素B、唑类和卡泊芬净）。由于缺乏研究，两种药物联合使用尚未得到验证，在医学实践中也不被推荐。这项药物经济学研究的目的是评估与标准治疗相比的不同治疗策略。研究采用了医疗保健系统的视角。结果表明，就成本而言，脂质体两性霉素B是未记录感染期间的参考标准药物。但是，伏立康唑治疗曲霉菌病的成本没有显著变化。对于念珠菌病，卡泊芬净也有同样的结论。敏感性分析表明，每日治疗成本和体重是对结果有重要影响的变量。为了评估不同的抗真菌治疗方法，必须通过临床研究继续进行这项初步分析。
