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Post-Transplant Complications

Economic evaluation of posaconazole vs fluconazole in the prevention of invasive fungal infections in patients with GVHD following haematopoietic SCT

Bone Marrow Transplantation volume 45, pages 925–932 (2010)Cite this article

A Corrigendum to this article was published on 12 May 2010

Abstract

Posaconazole has been proven to be as effective as fluconazole in the prevention of invasive fungal infections (IFI) in allogeneic haematopoietic SCT patients with GVHD. We assessed, from the perspective of the Spanish National Health Service, the cost-effectiveness of posaconazole vs fluconazole in preventing IFI. A decision-analytic model was developed to assess the average per patient treatment costs, IFIs avoided, life-years gained (LYG) and incremental cost per LYG for each prophylactic treatment used (in euros at 2007 prices). Patients are assumed to have received either posaconazole or fluconazole. The probabilities of IFI, IFI-related death and death from other causes were obtained from a single clinical trial. Long-term mortality and costs were estimated from secondary sources. Posaconazole was associated with fewer IFIs (5.3 vs 9%), increased LYG (8.01 vs 7.78) and higher IFI-related costs (€11 585 vs €6 959) per patient compared with fluconazole. The incremental cost-effectiveness of posaconazole vs fluconazole was estimated at €20 246 per LYG. There was a 70% probability that posaconazole is cost-effective at a €30 000 per LYG threshold. In conclusion, compared with fluconazole, posaconazole prophylaxis is a cost-effective strategy for the prevention of IFI in patients with GVHD.

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Acknowledgements

The authors thank Amy O'Sullivan from i3Innovus for programming the model. This study received an unconditional grant from Schering-Plough SA. The authors had independence with respect to study design, analysis and interpretation of the data, report writing, and the decision to publish.

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Authors and Affiliations

  1. Department of Haematology, Hospital de la Princesa, Madrid, Spain

    R de la Cámara

  2. Department of Haematology, Hospital Universitario La Fe, Valencia, Spain

    I Jarque & M A Sanz

  3. Department of Haematology, Hospital del Mar, Barcelona, Spain

    S Grau

  4. Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain

    M A Casado

  5. Health Economics Department, Schering-Plough SA, Madrid, Spain

    F J Sabater

  6. Pharmacy Department, Hospital Clinic, Barcelona, Spain

    E Carreras

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  1. R de la Cámara
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Correspondence to R de la Cámara.

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Cámara, R., Jarque, I., Sanz, M. et al. Economic evaluation of posaconazole vs fluconazole in the prevention of invasive fungal infections in patients with GVHD following haematopoietic SCT. Bone Marrow Transplant 45, 925–932 (2010). https://doi.org/10.1038/bmt.2009.272

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