Advanced Search

Cost Effectiveness of Itraconazole in the Prophylaxis of Invasive Fungal Infections

Contents:

Author Info

  • Robin de Vries

    (Groningen Research Institute of Pharmacy (GRIP), University of Groningen, Groningen, The Netherlands)

  • Simon Daenen

    (University Medical Centre Groningen (UMCG), Groningen, The Netherlands)

  • Keith Tolley

    (Ortho Biotech, High Wycombe, UK)

  • Axel Glasmacher

    (University Hospital Bonn, Bonn, Germany)

  • Archie Prentice

    (Derriford Hospital, Plymouth, UK)

  • Sarah Howells

    (Ortho Biotech, High Wycombe, UK)

  • Hariette Christopherson

    (Ortho Biotech, High Wycombe, UK)

  • Lolkje T.W. de Jong-van den Berg

    (Groningen Research Institute of Pharmacy (GRIP), University of Groningen, Groningen, The Netherlands)

  • Maarten J. Postma

    (Groningen Research Institute of Pharmacy (GRIP), University of Groningen, Groningen, The Netherlands)

Registered author(s):

    Abstract

    Background: Invasive fungal infections in neutropenic patients treated for haematological malignancies are associated with a high mortality rate and, therefore, require early treatment. As the diagnosis of invasive fungal infections is difficult, effective antifungal prophylaxis is desirable. So far, fluconazole has been the most commonly used. Objective: To assess the cost effectiveness of itraconazole compared with both fluconazole and no prophylaxis for the prevention of invasive fungal infections in haematological patients, mean age 51 years, in Germany and The Netherlands. Study design: We designed a probabilistic decision model to fully incorporate the uncertainty associated with the risk estimates of acquiring an invasive fungal infection. These risk estimates were extracted from two meta-analyses, evaluating the effectiveness of fluconazole and itraconazole and no prophylaxis. The perspective of the analysis was that of the healthcare sector; only medical costs were taken into account. All costs were reported in _, year 2004 values. Cost effectiveness was expressed as net costs per invasive fungal infection averted. No discounting was performed, as the model followed patients during their neutropenic period, which was assumed to be less than 1 year. Results: According to our probabilistic decision model, the monetary benefits of averted healthcare exceed the costs of itraconazole prophylaxis under baseline assumptions (95% CI: from cost-saving to _5000 per invasive fungal infection averted). Compared with fluconazole, itraconazole is estimated to be both more effective and more economically favourable, with a probability of almost 98%. Conclusions: In specific groups of neutropenic patients treated for haematological malignancies, itraconazole prophylaxis could potentially reduce overall healthcare expenditure, without harming effectiveness, in settings where fluconazole is common practice in the prophylaxis of invasive fungal infections.

    Download Info

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
    File URL: http://pharmacoeconomics.adisonline.com/pt/re/phe/pdfhandler.00019053-200826010-00007.pdf
    Download Restriction: Pay per view

    File URL: http://pharmacoeconomics.adisonline.com/pt/re/phe/fulltext.00019053-200826010-00007.htm
    Download Restriction: Pay per view

    As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

    Bibliographic Info

    Article provided by Springer Healthcare | Adis in its journal PharmacoEconomics.

    Volume (Year): 26 (2008)
    Issue (Month): 1 ()
    Pages: 75-90
    Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
    Handle: RePEc:wkh:phecon:v:26:y:2008:i:1:p:75-90

    Contact details of provider:
    Web page: http://pharmacoeconomics.adisonline.com/

    For corrections or technical questions regarding this item, or to correct its listing, contact: (Dave Dustin).

    Related research

    Keywords: Aspergillosis; Aspergillosis; Candidiasis; Candidiasis; Cost-effectiveness; Fluconazole; Haematological-malignancies; Itraconazole; Mycoses; Mycoses;

    Find related papers by JEL classification:

    References

    No references listed on IDEAS
    You can help add them by filling out this form.

    Citations

    Lists

    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

    Statistics

    Access and download statistics

    Corrections

    When requesting a correction, please mention this item's handle: RePEc:wkh:phecon:v:26:y:2008:i:1:p:75-90

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dave Dustin).

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If references are entirely missing, you can add them using this form.

    If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.