Cost-effectiveness of caspofungin versus liposomal amphotericin B in the treatment of systemic fungal infections: a systematic review of economic analyses.
BACKGROUND
The treatment of fungal infections in severely ill patients is a clinical and economic challenge worldwide. Liposomal amphotericin B and caspofungin are highly effective antifungal drugs; however, they are very expensive and health systems must select the drug that results in the best clinical outcomes and is economically feasible.


METHODS
A systematic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, Health Economic Evaluation Database, and Centre for Review and Dissemination to find complete economic evaluations that directly compared the two treatment strategies. Expert commentary: Because of the high cost, patients in developing countries experience difficulty accessing highly effective treatments. These data can subsidize a decision for an effective antifungal treatment with reduced costs from all perspectives.
a Instituto Multidisciplinar em Saúde , Universidade Federal da Bahia Ringgold , Vitória da Conquista , Brazil.
Sóstenes
S
Mistro
a Instituto Multidisciplinar em Saúde , Universidade Federal da Bahia Ringgold , Vitória da Conquista , Brazil.
Lorena
L
Rosa
b Hospital Universitário Professor Edgard Santos , Universidade Federal da Bahia Ringgold , Salvador , Brazil.
Bárbara
B
Gomes
b Hospital Universitário Professor Edgard Santos , Universidade Federal da Bahia Ringgold , Salvador , Brazil.
Lígia
L
Miranda
c Faculdade de Medicina , Universidade Federal da Bahia Ringgold , Salvador , Brazil.
Roberto
R
Badaró
D000666:Amphotericin B / Q000191:economics / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000191:economics / Q000627:therapeutic use; D000077336:Caspofungin; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D054714:Echinocandins / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D055666:Lipopeptides / Q000191:economics / Q000627:therapeutic use*; D009181:Mycoses / Q000188:drug therapy* / Q000191:economics; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; C068538:liposomal amphotericin B; D000666:Amphotericin B; D000077336:Caspofungin
Liposomal amphotericin B; caspofungin; cost-effectiveness; pharmacoeconomics; review; severely ill patients