title: Pharmacoeconomic assessment of therapy for invasive aspergillosis.
abstract: Invasive aspergillosis (IA) is a major cause of morbidity and mortality in immunocompromised hosts. Economic expenditures prompted by this invasive fungal infection (IFI) are significant. Although, the duration and associated costs of hospitalization comprise the largest proportion of costs in large surveillance studies, the newer oral antifungal agents may impact significantly on these costs. A review of the pharmacoeconomic (PE) studies is provided focussing on primary therapy, salvage therapy, empiric therapy and prophylaxis for IA. PE evaluations have demonstrated the cost effectiveness and dominance of voriconazole for targeted primary treatment of IA compared with other available agents. Differences in the drug choice and analytic methodology of the PE analyses of empiric antifungal strategy hamper definitive conclusions about the agents employed as empiric antifungal that may be directed at suspected IA although both caspofungin and voriconazole appear to be cost effective and dominant over liposomal amphotericin B (LAmB), whereas LAmB is more costly than conventional amphotericin B. Posaconazole is the most cost-effective agent for antifungal prophylaxis against IFI and IA.
authors: Division of Infectious Diseases, Department of Medicine, University of Toronto, University Health Network, Toronto, Ontario, Canada.
authors: Me-Linh
authors: ML
authors: Luong
authors: Shahid
authors: S
authors: Husain
authors: Coleman
authors: C
authors: Rotstein
mesh_terms: D000666:Amphotericin B / Q000191:economics / Q000627:therapeutic use; D000935:Antifungal Agents / Q000191:economics* / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy* / Q000191:economics; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D036262:Empirical Research; D006801:Humans; D007902:Length of Stay / Q000191:economics; D011743:Pyrimidines / Q000191:economics* / Q000627:therapeutic use; D016896:Treatment Outcome; D014230:Triazoles / Q000191:economics* / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; C068538:liposomal amphotericin B; C101425:posaconazole; D000666:Amphotericin B; D065819:Voriconazole