Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers University, NJ, USA.
Int J Antimicrob Agents. 2013 Sep;42(3):276-80. doi: 10.1016/j.ijantimicag.2013.04.030. Epub 2013 Jul 4.
Invasive fungal infections (IFIs) are a major concern within healthcare systems. This pharmacoeconomic study evaluated the use of caspofungin (CAS) versus liposomal amphotericin B (L-AmB) in the empirical treatment of IFIs within the Turkish healthcare system. A decision-analytic model was adopted, utilising data from a randomised, non-inferiority clinical trial and a panel of clinical experts in Turkey. A five-point composite outcome measure was used to evaluate both agents. Sensitivity analyses were performed. In the base-case scenario, CAS was preferred over L-AmB by Turkish Lira (TL) 3961 per patient treated, TL 12 904 per successfully treated patient and TL 3972 per death averted. One-way sensitivity analysis did not change the study outcome. Monte Carlo simulation concluded a 71.0% chance of the outcome favouring CAS. The results were most sensitive to changes in length of stay. This is the first economic evaluation of the empirical treatment of IFIs in Turkey and suggests that CAS is more cost effective than L-AmB.
侵袭性真菌感染（IFI）是医疗保健系统中的一个主要关注点。这项药物经济学研究评估了卡泊芬净（CAS）与两性霉素 B 脂质体（L-AmB）在土耳其医疗保健系统中用于IFI 经验性治疗的应用。采用了决策分析模型，利用了来自一项随机、非劣效性临床试验和土耳其一组临床专家的数据。使用了五点综合结果测量来评估两种药物。进行了敏感性分析。在基本情况下，与 L-AmB 相比，每例治疗患者土耳其里拉（TL）节省 3961 里拉，每例成功治疗患者节省 12904 里拉，每例避免死亡节省 3972 里拉。单因素敏感性分析并未改变研究结果。蒙特卡罗模拟得出结论，结果有利于 CAS 的可能性为 71.0%。结果对住院时间的变化最为敏感。这是对土耳其IFI 经验性治疗进行的首次经济评估，表明 CAS 比 L-AmB 更具成本效益。
