Servicio de Farmacia, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.
J Mycol Med. 2013 Sep;23(3):155-63. doi: 10.1016/j.mycmed.2013.05.004. Epub 2013 Jul 9.
Candidaemia and invasive Candida infections can cause patient death and are expensive. Anidulafungin, a newly-licensed candin, has proven effective in treating candidaemia. Our study evaluates the cost-effectiveness of anidulafungin compared with fluconazole, the current standard of care, for treating invasive candidiasis and candidaemia in Spain.
A decision tree model from the hospital perspective was constructed to examine the cost-effectiveness of anidulafungin compared with fluconazole in treating confirmed candidaemia. Treatment success, patient treatment patterns, and patient survival were based on the results from a randomised, double-blind multicentre trial (Reboli et al., 2007 [41]). Only in-hospital (2011 €) direct costs per-patient obtained from a Spanish national database were considered. Renal toxicity probabilities and costs were extracted from the published literature. The incremental cost per successfully treated patient was calculated. One-way sensitivity analyses were performed to test model robustness.
The percentage of successfully treated patients was higher with anidulafungin than with fluconazole (74% versus 57%). Treatment with anidulafungin resulted in higher antifungal drug costs (5991€ versus 3149€) but lower overall costs (40047€ versus 41350€) due to reductions in other medical costs. Univariate sensitivity analyses showed that anidulafungin was the most cost-effective.
Anidulafungin demonstrated improved clinical efficacy versus fluconazole in treating confirmed candidaemia. Despite increased drug costs, treating confirmed candidaemia with anidulafungin is a cost-effective strategy.
念珠菌血症和侵袭性念珠菌感染可导致患者死亡，且费用高昂。安尼卡fungin（一种新批准的 Candin）已被证明对治疗念珠菌血症有效。我们的研究评估了安尼卡fungin 与氟康唑（目前的标准治疗方法）治疗西班牙侵袭性念珠菌病和念珠菌血症的成本效益。
从医院角度构建决策树模型，以检查安尼卡fungin 与氟康唑治疗确诊念珠菌血症的成本效益。治疗成功率、患者治疗模式和患者生存率基于一项随机、双盲、多中心试验（Reboli 等人，2007 年[41]）的结果。仅考虑从西班牙国家数据库获得的每位患者的住院（2011 欧元）直接成本。从已发表的文献中提取肾功能毒性的概率和成本。计算成功治疗的每位患者的增量成本。进行了单因素敏感性分析以测试模型的稳健性。
与氟康唑相比，安尼卡fungin 治疗的成功患者比例更高（74%对 57%）。使用安尼卡fungin 治疗导致抗真菌药物成本更高（5991 欧元对 3149 欧元），但总成本更低（40047 欧元对 41350 欧元），因为其他医疗费用减少。单因素敏感性分析表明，安尼卡fungin 是最具成本效益的。
与氟康唑相比，安尼卡fungin 治疗确诊念珠菌血症的临床疗效有所改善。尽管药物成本增加，但使用安尼卡fungin 治疗确诊念珠菌血症是一种具有成本效益的策略。
