title: Echinocandins in the treatment of candidaemia and invasive candidiasis: clinical and economic perspectives.
abstract: Candidaemia and invasive candidiasis (IC) complicate modern medical therapy, contributing to high morbidity and mortality. Managing candidiasis is costly, with an additional healthcare expenditure of nearly US$300 million annually. Recent consensus guidelines have suggested the use of newer antifungal agents, such as echinocandins, for the treatment of candidaemia and IC owing to promising clinical outcomes compared with older-generation antifungal agents, but at higher drug acquisition and administration costs. Comprehensive cost-effectiveness data for echinocandins in treating candidaemia and IC remain relatively scant, underlining the need for more studies to incorporate robust economic analyses into clinical decisions. Assessment of the cost efficiencies of these expensive antifungal agents is essential for maximising health outcomes within the constraints of healthcare resources. This review will explore the epidemiology of candidaemia and IC in the context of clinical and economic aspects of the antifungal agents used to treat IC, especially the echinocandins. Standardising the outcome measure, methodology and reporting of results used in economic studies is central to ensure validity and comparability of the findings. Future studies comparing the economic advantages of all available antifungal treatment options and in the context of new diagnostic tools for fungal infections are anticipated.
authors.affiliation: Faculty of Pharmacy, University of Technology MARA, 13200 Kepala Batas, Penang, Malaysia; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia.
authors.forename: Chin Fen
authors.initials: CF
authors.lastname: Neoh
authors.affiliation: Department of Infectious Diseases, Peter MacCallum Cancer Centre, St Andrew's Place, East Melbourne, VIC 3002, Australia.
authors.forename: Monica
authors.initials: M
authors.lastname: Slavin
authors.affiliation: Centre for Infectious Diseases and Microbiology, University of Sydney, Westmead Hospital, P.O. Box 533, Wentworthville, NSW 2145, Australia.
authors.forename: Sharon C-A
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia.
authors.forename: Kay
authors.initials: K
authors.lastname: Stewart
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia. Electronic address: david.kong@monash.edu.
authors.forename: David C M
authors.initials: DC
authors.lastname: Kong
mesh_terms: D000935:Antifungal Agents / Q000191:economics / Q000627:therapeutic use*; D058365:Candidiasis, Invasive / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D003362:Cost-Benefit Analysis; D054714:Echinocandins / Q000191:economics / Q000627:therapeutic use*; D017048:Health Care Costs; D006801:Humans
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins
keywords: Candida infection; Costs; Echinocandins