Cargando…
The cost‐effectiveness of isavuconazole compared to voriconazole, the standard of care in the treatment of patients with invasive mould diseases, prior to differential pathogen diagnosis in Spain
BACKGROUND: Invasive mould diseases are associated with high morbidity, mortality and economic impact. Its treatment is often started prior to differential pathogen diagnosis. Isavuconazole is approved for treatment of invasive aspergillosis (IA) and invasive mucormycosis (IM) when amphotericin‐B is...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894146/ https://www.ncbi.nlm.nih.gov/pubmed/32989796 http://dx.doi.org/10.1111/myc.13189 |
_version_ | 1783653186450489344 |
---|---|
author | Azanza, José Ramón Grau, Santiago Vázquez, Lourdes Rebollo, Pablo Peral, Carmen López‐Ibáñez de Aldecoa, Alejandra López‐Gómez, Vanessa |
author_facet | Azanza, José Ramón Grau, Santiago Vázquez, Lourdes Rebollo, Pablo Peral, Carmen López‐Ibáñez de Aldecoa, Alejandra López‐Gómez, Vanessa |
author_sort | Azanza, José Ramón |
collection | PubMed |
description | BACKGROUND: Invasive mould diseases are associated with high morbidity, mortality and economic impact. Its treatment is often started prior to differential pathogen diagnosis. Isavuconazole is approved for treatment of invasive aspergillosis (IA) and invasive mucormycosis (IM) when amphotericin‐B is not indicated. OBJECTIVES: To estimate the cost‐effectiveness of isavuconazole vs voriconazole for the treatment of adult patients with possible IA prior to differential pathogen diagnosis, in Spain. METHODS: A decision tree analysis was performed using the Spanish Healthcare System perspective. Among all patients with possible IA, it was considered that 7.81% actually had IM. Costs for laboratory analysis, management of adverse events, hospitalisation and drugs per patient, deaths and long‐term effects in life years (LYs) and quality‐adjusted LYs (QALYs) were considered. Efficacy data were obtained from clinical trials and utilities from the literature. Deterministic and probabilistic sensitivity analyses (PSA) were conducted. RESULTS: In patients with possible IA and when compared to voricanozole, isavuconazole showed an incremental cost of 4758.53€, besides an incremental effectiveness of +0.49 LYs and +0.41 QALYs per patient. The Incremental Cost Effectiveness Ratio was 9622.52€ per LY gained and 11,734.79€ per QALY gained. The higher cost of isavuconazole was due to drug acquisition. Main parameters influencing results were mortality, treatment duration and hospitalisation days. The PSA results showed that isavuconazole has a probability of being cost‐effective of 67.34%, being dominant in 24.00% of cases. CONCLUSIONS: Isavuconazole is a cost‐effective treatment compared to voriconazole for patients with possible IA for a willingness to pay threshold of 25,000€ per additional QALY. |
format | Online Article Text |
id | pubmed-7894146 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78941462021-03-02 The cost‐effectiveness of isavuconazole compared to voriconazole, the standard of care in the treatment of patients with invasive mould diseases, prior to differential pathogen diagnosis in Spain Azanza, José Ramón Grau, Santiago Vázquez, Lourdes Rebollo, Pablo Peral, Carmen López‐Ibáñez de Aldecoa, Alejandra López‐Gómez, Vanessa Mycoses Original Articles BACKGROUND: Invasive mould diseases are associated with high morbidity, mortality and economic impact. Its treatment is often started prior to differential pathogen diagnosis. Isavuconazole is approved for treatment of invasive aspergillosis (IA) and invasive mucormycosis (IM) when amphotericin‐B is not indicated. OBJECTIVES: To estimate the cost‐effectiveness of isavuconazole vs voriconazole for the treatment of adult patients with possible IA prior to differential pathogen diagnosis, in Spain. METHODS: A decision tree analysis was performed using the Spanish Healthcare System perspective. Among all patients with possible IA, it was considered that 7.81% actually had IM. Costs for laboratory analysis, management of adverse events, hospitalisation and drugs per patient, deaths and long‐term effects in life years (LYs) and quality‐adjusted LYs (QALYs) were considered. Efficacy data were obtained from clinical trials and utilities from the literature. Deterministic and probabilistic sensitivity analyses (PSA) were conducted. RESULTS: In patients with possible IA and when compared to voricanozole, isavuconazole showed an incremental cost of 4758.53€, besides an incremental effectiveness of +0.49 LYs and +0.41 QALYs per patient. The Incremental Cost Effectiveness Ratio was 9622.52€ per LY gained and 11,734.79€ per QALY gained. The higher cost of isavuconazole was due to drug acquisition. Main parameters influencing results were mortality, treatment duration and hospitalisation days. The PSA results showed that isavuconazole has a probability of being cost‐effective of 67.34%, being dominant in 24.00% of cases. CONCLUSIONS: Isavuconazole is a cost‐effective treatment compared to voriconazole for patients with possible IA for a willingness to pay threshold of 25,000€ per additional QALY. John Wiley and Sons Inc. 2020-10-30 2021-01 /pmc/articles/PMC7894146/ /pubmed/32989796 http://dx.doi.org/10.1111/myc.13189 Text en © 2020 Pfizer SLU. Mycoses published by Wiley‐VCH GmbH This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Azanza, José Ramón Grau, Santiago Vázquez, Lourdes Rebollo, Pablo Peral, Carmen López‐Ibáñez de Aldecoa, Alejandra López‐Gómez, Vanessa The cost‐effectiveness of isavuconazole compared to voriconazole, the standard of care in the treatment of patients with invasive mould diseases, prior to differential pathogen diagnosis in Spain |
title | The cost‐effectiveness of isavuconazole compared to voriconazole, the standard of care in the treatment of patients with invasive mould diseases, prior to differential pathogen diagnosis in Spain |
title_full | The cost‐effectiveness of isavuconazole compared to voriconazole, the standard of care in the treatment of patients with invasive mould diseases, prior to differential pathogen diagnosis in Spain |
title_fullStr | The cost‐effectiveness of isavuconazole compared to voriconazole, the standard of care in the treatment of patients with invasive mould diseases, prior to differential pathogen diagnosis in Spain |
title_full_unstemmed | The cost‐effectiveness of isavuconazole compared to voriconazole, the standard of care in the treatment of patients with invasive mould diseases, prior to differential pathogen diagnosis in Spain |
title_short | The cost‐effectiveness of isavuconazole compared to voriconazole, the standard of care in the treatment of patients with invasive mould diseases, prior to differential pathogen diagnosis in Spain |
title_sort | cost‐effectiveness of isavuconazole compared to voriconazole, the standard of care in the treatment of patients with invasive mould diseases, prior to differential pathogen diagnosis in spain |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894146/ https://www.ncbi.nlm.nih.gov/pubmed/32989796 http://dx.doi.org/10.1111/myc.13189 |
work_keys_str_mv | AT azanzajoseramon thecosteffectivenessofisavuconazolecomparedtovoriconazolethestandardofcareinthetreatmentofpatientswithinvasivemoulddiseasespriortodifferentialpathogendiagnosisinspain AT grausantiago thecosteffectivenessofisavuconazolecomparedtovoriconazolethestandardofcareinthetreatmentofpatientswithinvasivemoulddiseasespriortodifferentialpathogendiagnosisinspain AT vazquezlourdes thecosteffectivenessofisavuconazolecomparedtovoriconazolethestandardofcareinthetreatmentofpatientswithinvasivemoulddiseasespriortodifferentialpathogendiagnosisinspain AT rebollopablo thecosteffectivenessofisavuconazolecomparedtovoriconazolethestandardofcareinthetreatmentofpatientswithinvasivemoulddiseasespriortodifferentialpathogendiagnosisinspain AT peralcarmen thecosteffectivenessofisavuconazolecomparedtovoriconazolethestandardofcareinthetreatmentofpatientswithinvasivemoulddiseasespriortodifferentialpathogendiagnosisinspain AT lopezibanezdealdecoaalejandra thecosteffectivenessofisavuconazolecomparedtovoriconazolethestandardofcareinthetreatmentofpatientswithinvasivemoulddiseasespriortodifferentialpathogendiagnosisinspain AT lopezgomezvanessa thecosteffectivenessofisavuconazolecomparedtovoriconazolethestandardofcareinthetreatmentofpatientswithinvasivemoulddiseasespriortodifferentialpathogendiagnosisinspain AT azanzajoseramon costeffectivenessofisavuconazolecomparedtovoriconazolethestandardofcareinthetreatmentofpatientswithinvasivemoulddiseasespriortodifferentialpathogendiagnosisinspain AT grausantiago costeffectivenessofisavuconazolecomparedtovoriconazolethestandardofcareinthetreatmentofpatientswithinvasivemoulddiseasespriortodifferentialpathogendiagnosisinspain AT vazquezlourdes costeffectivenessofisavuconazolecomparedtovoriconazolethestandardofcareinthetreatmentofpatientswithinvasivemoulddiseasespriortodifferentialpathogendiagnosisinspain AT rebollopablo costeffectivenessofisavuconazolecomparedtovoriconazolethestandardofcareinthetreatmentofpatientswithinvasivemoulddiseasespriortodifferentialpathogendiagnosisinspain AT peralcarmen costeffectivenessofisavuconazolecomparedtovoriconazolethestandardofcareinthetreatmentofpatientswithinvasivemoulddiseasespriortodifferentialpathogendiagnosisinspain AT lopezibanezdealdecoaalejandra costeffectivenessofisavuconazolecomparedtovoriconazolethestandardofcareinthetreatmentofpatientswithinvasivemoulddiseasespriortodifferentialpathogendiagnosisinspain AT lopezgomezvanessa costeffectivenessofisavuconazolecomparedtovoriconazolethestandardofcareinthetreatmentofpatientswithinvasivemoulddiseasespriortodifferentialpathogendiagnosisinspain |