Document Detail

Cost-effectiveness of posaconazole versus fluconazole for prevention of invasive fungal infections in U.S. patients with graft-versus-host disease.
MedLine Citation:
PMID:  22215361     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The results of a pharmacoeconomic study of the cost-effectiveness of posaconazole versus fluconazole in preventing invasive fungal infections (IFIs) in patients with graft-versus-host disease (GVHD) are reported.
METHODS: The results of a randomized clinical trial suggested that posaconazole may be as effective as fluconazole for the prevention of IFIs in recipients of allogeneic cell transplants who develop severe GVHD and that posaconazole may be superior to fluconazole in reducing IFI-related deaths. Using published data from that trial and data from secondary sources, an economic model was developed to estimate the costs, IFIs avoided, and life-years saved with posaconazole versus fluconazole therapy. The results of the modeled 112-day treatment simulation were extrapolated to a lifetime horizon.
RESULTS: In the modeled simulation, posaconazole therapy was associated with a lower probability of IFI development (0.05 versus 0.09), increased discounted life-years (7.87 life-years versus 7.66 life-years), and higher discounted costs per patient ($8,860 versus $5,710 in 2006 U.S. dollars) relative to fluconazole therapy. The estimated incremental cost-effectiveness of posaconazole versus fluconazole for IFI prophylaxis was $85,300 per IFI avoided and $15,300 per life-year saved. A sensitivity analysis indicated a 90% probability that the use of posaconazole for this purpose would be cost-effective at a threshold of $50,000 per life-year saved.
CONCLUSION: Posaconazole is in the range of currently accepted criteria for cost- effectiveness relative to fluconazole for the prevention of IFIs among patients with GVHD.
Amy K O'Sullivan; Milton C Weinstein; Ankur Pandya; David Thompson; Amelia A Langston; John R Perfect; George Papadopoulos
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists     Volume:  69     ISSN:  1535-2900     ISO Abbreviation:  Am J Health Syst Pharm     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-04     Completed Date:  2012-04-23     Revised Date:  2012-07-05    
Medline Journal Info:
Nlm Unique ID:  9503023     Medline TA:  Am J Health Syst Pharm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  149-56     Citation Subset:  IM    
Global Health Economics Research, i3 Innovus, Medford, MA, USA.
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MeSH Terms
Antifungal Agents / economics,  therapeutic use*
Cost-Benefit Analysis
Fluconazole / economics,  therapeutic use*
Graft vs Host Disease / complications
Itraconazole / economics,  therapeutic use*
Models, Economic
Mycoses / economics,  prevention & control*
Severity of Illness Index
Transplantation, Homologous
United States
Reg. No./Substance:
0/Antifungal Agents; 84625-61-6/Itraconazole; 86386-73-4/Fluconazole
Comment In:
Am J Health Syst Pharm. 2012 Jun 1;69(11):917-22; author reply 922   [PMID:  22610019 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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