title: Pharmacoeconomic evaluation of caspofungin versus liposomal amphotericin B in empirical treatment of invasive fungal infections in Turkey.
abstract: 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.
authors.affiliation: Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers University, NJ, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Turner
authors.forename: E
authors.initials: E
authors.lastname: Senol
authors.forename: A
authors.initials: A
authors.lastname: Kara
authors.forename: D
authors.initials: D
authors.lastname: Al-Badriyeh
authors.forename: D C M
authors.initials: DC
authors.lastname: Kong
authors.forename: E C
authors.initials: EC
authors.lastname: Dinleyici
mesh_terms: D000666:Amphotericin B / Q000191:economics* / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000191:economics / Q000627:therapeutic use; D000077336:Caspofungin; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D054714:Echinocandins / Q000191:economics* / Q000627:therapeutic use*; D064147:Febrile Neutropenia / Q000188:drug therapy / Q000382:microbiology; D005334:Fever / Q000188:drug therapy / Q000191:economics; D006801:Humans; D055666:Lipopeptides; D008826:Microbial Sensitivity Tests; D009181:Mycoses / Q000188:drug therapy* / Q000191:economics; D014421:Turkey
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; C068538:liposomal amphotericin B; D000666:Amphotericin B; D000077336:Caspofungin
keywords: Antifungal agents; Caspofungin; Economic evaluation; Empirical therapy; Invasive fungal infection; Liposomal amphotericin B