Posaconazole vs fluconazole or itraconazole for prevention of invasive fungal diseases in patients with acute myeloid leukemia or myelodysplastic syndrome: a cost-effectiveness analysis in an Asian teaching hospital
| Autor: | Yu-Yan Hwang, Thomas S. Y. Chan, Yok-Lam Kwong, Harinder Gill, Stephen Marcella |
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| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Posaconazole Antifungal Agents Itraconazole Cost-Benefit Analysis Neutropenia Decision Support Techniques 03 medical and health sciences 0302 clinical medicine Internal medicine Case fatality rate medicine Humans 030212 general & internal medicine Intensive care medicine Hospitals Teaching Fluconazole health care economics and organizations business.industry Health Policy Myelodysplastic syndromes Myeloid leukemia Cost-effectiveness analysis Triazoles medicine.disease Leukemia Myeloid Acute Mycoses Socioeconomic Factors 030220 oncology & carcinogenesis Myelodysplastic Syndromes Hong Kong business Models Econometric medicine.drug |
| DOI: | 10.6084/m9.figshare.1609726.v2 |
| Popis: | Background:Posaconazole is superior to fluconazole/itraconazole in preventing invasive fungal diseases (IFDs) in neutropenic patients. Whether the higher cost of posaconazole is offset by decreases in IFDs in a given institute requires cost-effective analysis encompassing the spectrum of IFDs and socioeconomic factors specific to that geographic area.Methods:This study performed a cost-effective analysis of posaconazole prophylaxis for IFDs in an Asian teaching hospital, employing decision modeling and data of IFDs and medication costs specific to the institute, in neutropenic patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS).Results:In the cost-effectiveness analysis, the higher cost of posaconazole was partially offset by a reduction in the cost of treating IFDs that were prevented, resulting in an incremental cost of 125,954 Hong Kong dollars/16,148 USD per IFD avoided. Over a lifetime horizon, assuming same case fatality rate of IFDs in both groups, use of posaconazole results in 0.07 discounted life years saved. This corresponds to an incremental cost of 116,023 HKD/14,875 USD per life year saved. This incremental cost per life year saved in posaconazole prophylaxis fulfilled the World Health Organization defined threshold for cost-effectiveness.Conclusion:Posaconazole prophylaxis was cost-effective in Hong Kong. |
| Databáze: | OpenAIRE |
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