title: Economic analysis of micafungin versus liposomal amphotericin B for treatment of candidaemia and invasive candidiasis in Germany.
abstract: OBJECTIVE
  To investigate the economic impact of micafungin (MICA) for treatment of invasive candidiasis and candidaemia (systemic Candida infections), a health economic analysis was conducted comparing MICA with liposomal amphotericin B (L-AMB).
  
  
  METHODS
  The model was based on a phase III, randomised, double-blind, clinical trial which compared MICA with L-AMB. The model entailed a period of 14-20 weeks starting from initiation of treatment and was analysed from a German hospital perspective.
  
  
  METHODS
  The main outcome measures were defined as the percentage of patients achieving clinical and mycological response after initial treatment and who were alive at the end of the study (EOS), and the total treatment-associated costs over the study period.
  
  
  RESULTS
  The health economic analysis shows that with MICA, 52.9% of patients are successfully treated and were alive at EOS compared to 49.1% for L-AMB. In addition, MICA has, on average, lower treatment-associated costs than L-AMB with euro43 243 and euro49 216 per patient, respectively. Because the costs are lower and the effectiveness is higher for MICA in comparison with L-AMB, MICA is more cost-effective than L-AMB. However, the results of the probabilistic sensitivity analysis show that the differences cannot be considered significant due to a large variance, although MICA remained the most cost-effective option throughout the one-way sensitivity analyses.
  
  
  CONCLUSIONS
  The lower costs and higher effectiveness reported for MICA versus L-AMB in this analysis indicate that MICA may be a more cost-effective therapy in the treatment of invasive candidiasis and candidaemia when compared with L-AMB.
authors.affiliation: Klinikum der Universität, Kerpener Strasse 62, 50924, Köln, Germany.
authors.forename: O A
authors.initials: OA
authors.lastname: Cornely
authors.forename: M
authors.initials: M
authors.lastname: Sidhu
authors.forename: I
authors.initials: I
authors.lastname: Odeyemi
authors.forename: A K
authors.initials: AK
authors.lastname: van Engen
authors.forename: J M
authors.initials: JM
authors.lastname: van der Waal
authors.forename: O
authors.initials: O
authors.lastname: Schoeman
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage / Q000191:economics* / Q000494:pharmacology; D000935:Antifungal Agents / Q000008:administration & dosage / Q000191:economics* / Q000494:pharmacology; D002177:Candidiasis / Q000188:drug therapy* / Q000503:physiopathology; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D004311:Double-Blind Method; D054714:Echinocandins / Q000008:administration & dosage / Q000191:economics* / Q000494:pharmacology; D005858:Germany; D006801:Humans; D055666:Lipopeptides; D008074:Lipoproteins / Q000008:administration & dosage / Q000191:economics* / Q000494:pharmacology; D000077551:Micafungin; D018803:Models, Economic; D017063:Outcome Assessment, Health Care; D016032:Randomized Controlled Trials as Topic
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D008074:Lipoproteins; C068538:liposomal amphotericin B; D000666:Amphotericin B; D000077551:Micafungin