title: Cost-effectiveness of anidulafungin in confirmed candidaemia and other invasive Candida infections in Spain.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Servicio de Farmacia, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Grau
authors.forename: M
authors.initials: M
authors.lastname: Salavert
authors.forename: J
authors.initials: J
authors.lastname: Carlos Pozo Laderas
authors.forename: M
authors.initials: M
authors.lastname: García Vargas
authors.forename: J A
authors.initials: JA
authors.lastname: Barrueta
authors.forename: N
authors.initials: N
authors.lastname: Mir
mesh_terms: D000077612:Anidulafungin; D000935:Antifungal Agents / Q000191:economics / Q000627:therapeutic use; D058387:Candidemia / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D058365:Candidiasis, Invasive / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D054714:Echinocandins / Q000191:economics* / Q000627:therapeutic use*; D017048:Health Care Costs; D006801:Humans; D015337:Multicenter Studies as Topic / Q000191:economics / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic / Q000191:economics / Q000706:statistics & numerical data; D013030:Spain / Q000453:epidemiology
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D000077612:Anidulafungin
keywords: Analyse coût-efficacité; Anidulafungin; Anidulafungine; Antifongique; Antifungal; Candidaemia; Candidose invasive; Candidémie; Cost-effectiveness analysis; Fluconazole; Invasive candidiasis