Pharmacoeconomic evaluation of micafungin versus caspofungin as definitive therapy for candidaemia and invasive candidiasis (IC) in Turkey

• Published in: European Journal of Clinical Microbiology and Infectious Diseases
• Main Author: Neoh C.F.; Senol E.; Kara A.; Dinleyici E.C.; Turner S.J.; Kong D.C.M.
• Format: Article
• Language: English
• Published: Springer Verlag 2018
• Online Access: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85035084429&doi=10.1007%2fs10096-017-3147-9&partnerID=40&md5=be670a559f69f32a4ecf96b22a372221

Micafungin was shown to be as efficacious as caspofungin in treating patients with candidaemia and invasive candidiasis (IC). However, it remains unknown if micafungin or caspofungin is a cost-effective definitive therapy for candidaemia and IC in Turkey. The present study aimed to determine the economic impact of using micafungin versus caspofungin for treatment of candidaemia and IC in the Turkish setting. A decision analytic model was constructed and was populated with data (i.e. transition probabilities, duration of initial antifungal treatment, reasons for treatment failure, percentage of patients who stepped down to oral fluconazole, and duration on oral fluconazole) obtained from a published randomised clinical trial. Cost inputs were derived from the latest Turkish resources while data that were not readily available in the literature were estimated by expert panels. Oneway sensitivity analyses, threshold analyses, scenario analyses and probabilistic sensitivity analyses were conducted. Caspofungin (€2693) incurred a lower total cost than micafungin (€4422), with a net cost saving of €1729 per treated patient. Drug acquisition cost was the main cost driver for both study arms. The model outcome was robust over wide variations (of ±100.0% from the base case value) for all input parameters except for micafungin drug cost and the duration of initial treatment with micafungin. Caspofungin appears to be a cost-saving option in treating candidaemia and IC from the Turkish hospital perspective. © Springer-Verlag GmbH Germany, part of Springer Nature 2017.