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Cost-effectiveness of posaconazole versus fluconazole or itraconazole in the prevention of invasive fungal infections among neutropenic patients in the United States.

Publication ,  Journal Article
O'Sullivan, AK; Pandya, A; Papadopoulos, G; Thompson, D; Langston, A; Perfect, J; Weinstein, MC
Published in: Value Health
2009

OBJECTIVES: Clinical trial data indicate that posaconazole is superior to fluconazole (FLU) or itraconazole (ITRA) in preventing invasive fungal infections (IFIs) among neutropenic patients. Our objective was to assess the cost-effectiveness of posaconazole versus FLU or ITRA for prevention of IFIs among neutropenic patients. METHODS: We used modeling techniques to assess the cost-effectiveness of posaconazole versus FLU or ITRA in the prevention of IFIs among patients with acute myelogenous leukemia (AML) or myelodysplastic syndromes (MDS) and chemotherapy-induced neutropenia. The probabilities of experiencing an IFI, IFI-related death, and death from other causes over 100 days of follow-up were estimated from clinical trial data. Long-term mortality, drug costs, and IFI treatment costs were obtained from secondary sources. RESULTS: Posaconazole is associated with fewer IFIs per patient (0.05 vs. 0.11) relative to FLU or ITRA over 100 days of follow-up, and lower discounted costs ($3900 vs. $4500) and increased life-years (2.50 vs. 2.43 discounted) over a lifetime horizon. Results from a probabilistic sensitivity analysis indicate that there is a 73% probability that posaconazole is cost saving versus FLU or ITRA and a 96% probability that the incremental cost-effectiveness ratio for posaconazole is at or below $50,000 per life-year saved. CONCLUSIONS: We conclude that posaconazole is very likely to be a cost-effective alternative to FLU or ITRA in the prevention of IFIs among neutropenic patients with AML and MDS, and may result in cost savings.

Duke Scholars

Published In

Value Health

DOI

EISSN

1524-4733

Publication Date

2009

Volume

12

Issue

5

Start / End Page

666 / 673

Location

United States

Related Subject Headings

  • United States
  • Neutropenia
  • Mycoses
  • Models, Econometric
  • Middle Aged
  • Male
  • Life Tables
  • Itraconazole
  • Humans
  • Health Policy & Services
 

Citation

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O’Sullivan, A. K., Pandya, A., Papadopoulos, G., Thompson, D., Langston, A., Perfect, J., & Weinstein, M. C. (2009). Cost-effectiveness of posaconazole versus fluconazole or itraconazole in the prevention of invasive fungal infections among neutropenic patients in the United States. Value Health, 12(5), 666–673. https://doi.org/10.1111/j.1524-4733.2008.00486.x
O’Sullivan, Amy K., Ankur Pandya, George Papadopoulos, David Thompson, Amelia Langston, John Perfect, and Milton C. Weinstein. “Cost-effectiveness of posaconazole versus fluconazole or itraconazole in the prevention of invasive fungal infections among neutropenic patients in the United States.Value Health 12, no. 5 (2009): 666–73. https://doi.org/10.1111/j.1524-4733.2008.00486.x.
O’Sullivan AK, Pandya A, Papadopoulos G, Thompson D, Langston A, Perfect J, et al. Cost-effectiveness of posaconazole versus fluconazole or itraconazole in the prevention of invasive fungal infections among neutropenic patients in the United States. Value Health. 2009;12(5):666–73.
O’Sullivan, Amy K., et al. “Cost-effectiveness of posaconazole versus fluconazole or itraconazole in the prevention of invasive fungal infections among neutropenic patients in the United States.Value Health, vol. 12, no. 5, 2009, pp. 666–73. Pubmed, doi:10.1111/j.1524-4733.2008.00486.x.
O’Sullivan AK, Pandya A, Papadopoulos G, Thompson D, Langston A, Perfect J, Weinstein MC. Cost-effectiveness of posaconazole versus fluconazole or itraconazole in the prevention of invasive fungal infections among neutropenic patients in the United States. Value Health. 2009;12(5):666–673.
Journal cover image

Published In

Value Health

DOI

EISSN

1524-4733

Publication Date

2009

Volume

12

Issue

5

Start / End Page

666 / 673

Location

United States

Related Subject Headings

  • United States
  • Neutropenia
  • Mycoses
  • Models, Econometric
  • Middle Aged
  • Male
  • Life Tables
  • Itraconazole
  • Humans
  • Health Policy & Services