Skip Navigation



JAC Advance Access published online on February 22, 2005
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh535
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
55/3/352    most recent
dkh535v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Wenzel, R.
Right arrow Articles by Marciniak, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wenzel, R.
Right arrow Articles by Marciniak, A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

JAC © The British Society for Antimicrobial Chemotherapy 2005; all rights reserved
Received June 3, 2004
Revised September 24, 2004
Accepted November 10, 2004

Original article

Economic evaluation of voriconazole compared with conventional amphotericin B for the primary treatment of aspergillosis in immunocompromised patients

R. Wenzel 1*, A. Del Favero 2, C. Kibbler 3, T. Rogers 4, C. Rotstein 5, J. Mauskopf 6, S. Morris 7, H. Schlamm 8, P. Troke 9, and A. Marciniak 9

1 Department of Internal Medicine, Medical College of Virginia, Virginia Commonwealth University, Old City Hall, 1001 East Broad Street, 4th Floor Suite 405, P.O. Box 980663, Richmond, VA 23298-0663, USA
2 Institute of Internal Medicine and Oncology, University of Perugia, Perugia, Italy
3 Department of Medical Microbiology, Royal Free Hospital, London, UK
4 Department of Infectious Diseases, Imperial College, Hammersmith Hospital, London, UK
5 Hamilton Health Sciences, Hamilton, Ontario, Canada
6 RTI Health Solutions, Research Triangle Park, NC, USA
7 Department of Health Economics, Imperial College Management School, London, UK
8 Pfizer Inc, New York, USA
9 Pfizer Ltd, Sandwich, UK

* To whom correspondence should be addressed.
R. Wenzel, E-mail: rwenzel{at}hsc.vcu.edu


  Abstract

Objective: The objective of this study was to conduct an economic evaluation of voriconazole compared with conventional amphotericin B deoxycholate (CAB) using data from a recently reported randomized comparative trial in patients with various underlying immunosuppressive conditions. This trial demonstrated the superiority of voriconazole in terms of clinical response, survival and safety when used as primary therapy for invasive aspergillosis.

Methods: A decision analytic model was designed using an expert panel and populated primarily with efficacy and resource utilization data collected prospectively during the clinical trial. The analysis was carried out from the perspective of the health care system and all costs are reported in 2002 US dollars.

Results: Average total treatment costs per patient were 10% lower in the voriconazole arm (\$30 664) than in the CAB arm (\$34 144), resulting from reduced consumption of hospital resources and fewer changes in antifungal therapy. In the base case analysis, voriconazole provided an average saving of \$3481 per treated patient, resulted in a lower cost per survivor (\$43 310 versus \$58 971) and a lower cost per successfully treated patient (\$58 100 versus \$108 124) compared with CAB. Sensitivity analyses demonstrated that the cost savings observed were maintained over a wide range of alternative values for both unit costs and resource utilization, including length of hospital stay, time spent in intensive care units, bed day costs and the cost of lipid formulations of amphotericin B.

Conclusion: Incremental cost-effectiveness analysis indicated the dominance of voriconazole because of both lower costs and greater efficacy.

Keywords: RCT; cost-effectiveness; model; sensitivity analyses.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 J Antimicrob ChemotherHome page
D. Al-Badriyeh, D. Liew, K. Stewart, and D. C. M. Kong
Economic impact of caspofungin as compared with liposomal amphotericin B for empirical therapy in febrile neutropenia in Australia
J. Antimicrob. Chemother., June 1, 2009; 63(6): 1276 - 1285.
[Abstract] [Full Text] [PDF]

Home page
 Am J Health Syst PharmHome page
R. E Greene, J. Mauskopf, C. S. Roberts, T. Zyczynski, and H. T. Schlamm
Comparative cost-effectiveness of voriconazole and amphotericin B in treatment of invasive pulmonary aspergillosis
Am. J. Health Syst. Pharm., December 15, 2007; 64(24): 2561 - 2568.
[Abstract] [Full Text] [PDF]

Home page
 J Antimicrob ChemotherHome page
A. J. H. A. Ament, M. W. A. Hubben, P. E. Verweij, R. de Groot, A. Warris, J. P. Donnelly, J. v. t Wout, and J. L. Severens
Economic evaluation of targeted treatments of invasive aspergillosis in adult haematopoietic stem cell transplant recipients in the Netherlands: a modelling approach
J. Antimicrob. Chemother., August 1, 2007; 60(2): 385 - 393.
[Abstract] [Full Text] [PDF]

Home page
 Am J Health Syst PharmHome page
J. R. Wingard, H. L. Leather, C. A. Wood, W. C. Gerth, R. J. Lupinacci, M. L. Berger, and E. C. Mansley
Pharmacoeconomic analysis of caspofungin versus liposomal amphotericin B as empirical antifungal therapy for neutropenic fever
Am. J. Health Syst. Pharm., March 15, 2007; 64(6): 637 - 643.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.