Cost-Effectiveness of Posaconazole vs. First-Generation Triazoles for the Prevention of Invasive Fungal Infections Among High-Risk Patients With Hematological Malignancies in China
Bibliographic Data
| ID | 22080948 |
|---|---|
| Authors | Changcheng Shi (0000-0002-8879-4794, Hangzhou First People's Hospital), Jian Ye (0000-0003-2762-9717, Hangzhou First People's Hospital), Yaping Xie (0000-0001-9768-3730, Hangzhou First People's Hospital), Rong Dong (0000-0003-3607-7352, Hangzhou First People's Hospital), Weizhong Jin (0000-0001-9335-2336, Hangzhou First People's Hospital), Linling Wang (0000-0003-1092-0073, Shaoxing People's Hospital), Yingying Fang (0000-0001-6334-8635, Hangzhou Cancer Hospital), Qiyuan Shan (0000-0001-7830-1995, Zhejiang Chinese Medical University, corresponding author), Nengming Lin (0000-0001-5202-802X, Hangzhou First People's Hospital, corresponding author) |
| Year | 2022 |
| Volume | 10 |
| Pages | 884846-884846 |
| Publication date | 2022-05-17 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2296-2565 • E-ISSN: 2296-2565 |
| Publisher | Frontiers Media SA (PUBLISHER • CH) |
| DOI | 10.3389/fpubh.2022.884846 |
| PMID | 35655452 |
| OpenAlex | W4280542995 |
| Language | EN |
| References cited | 37 |
Background: Posaconazole is confirmed to be more effective for preventing invasive fungal infections (IFIs) than first-generation triazoles (fluconazole and itraconazole), but its economic value has not been comprehensively evaluated in China. This study compared the cost-effectiveness of these two antifungal prophylaxis regimens in hematological-malignancy patients at high risk for IFIs from the Chinese healthcare perspective. Methods: A hybrid decision tree and Markov model were built using published data to estimate the total costs and quality-adjusted life-years (QALYs) of antifungal prophylaxis with posaconazole oral suspension and first-generation triazoles. Regimens with an incremental cost-effectiveness ratio (ICER) lower than the threshold of willingness to pay (WTP) were considered cost-effective. One-way and probabilistic sensitivity analyses were performed to assess model robustness. The regional imbalance of economic development and the tablet formulation of posaconazole were considered in the scenario analyses. Results: In the base-case analysis, posaconazole oral suspension provided an additional 0.109 QALYs at an incremental cost of $954.7, yielding an ICER of $8,784.4/QALY, below the national WTP threshold of $31,315/QALY. One-way and probabilistic sensitivity analyses showed that the results were robust. Scenario analyses showed that the base-case ICER was consistently below the WTP thresholds of all 31 Chinese provinces, with the likelihood of posaconazole being cost-effectiveness ranging from 78.1 to 99.0%. When the posaconazole oral suspension was replaced by the tablet formulation, the ICER increased to $29,214.1/QALY, still below the national WTP threshold and WTP thresholds of 12 provinces. Conclusions: Posaconazole oral suspension is a highly cost-effective regimen for preventing IFI in high-risk hematological-malignancy patients from the Chinese healthcare perspective. Posaconazole tablets may also be considered in some high-income regions of China
Antifungal · Cost effectiveness · Cost-effectiveness analysis · Incremental cost-effectiveness ratio · Itraconazole · Posaconazole · Antifungal resistance and susceptibility · Fungal Infections and Studies · Medicine · Neutropenia and Cancer Infections
| Citation velocity | historical |
|---|---|
| Highly cited | No |