Show simple item record

AuthorHeng, Siow-Chin
AuthorSlavin, Monica A.
AuthorAl-Badriyeh, Daoud
AuthorKirsa, Sue
AuthorSeymour, John F.
AuthorGrigg, Andrew
AuthorThursky, Karin
AuthorBajel, Ashish
AuthorNation, Roger L.
AuthorKong, David C. M.
Available date2024-04-30T05:47:45Z
Publication Date2013
Publication NameJournal of Antimicrobial Chemotherapy
ResourceScopus
Identifierhttp://dx.doi.org/10.1093/jac/dkt068
ISSN3057453
URIhttp://hdl.handle.net/10576/54478
AbstractBackground: Fluconazole, posaconazole and voriconazole are used prophylactically in patients with acute myeloid leukaemia (AML). This study evaluated the clinical and economic outcomes of these agents when used in AML patients undergoing consolidation chemotherapy. Methods: A retrospective chart review (2003-10) of AML patients receiving consolidation chemotherapy was performed. Patients were followed through their first cycle of consolidation chemotherapy. Antifungal prescribing patterns, clinical outcomes and resource consumptions were recorded. A decision analytical model was developed to depict the downstream consequences of using each antifungal agent, with success defined as completion of the designated course of initial antifungal prophylaxis without developing invasive fungal disease (IFD). Cost-effectiveness and sensitivity analyses were performed. Results: A total of 106 consecutive patients were analysed. Baseline characteristics and predisposing factors for IFD were comparable between groups. Three IFDs (one proven, one probable and one suspected) occurred, all in the posaconazole group. Patients receiving posaconazole had the highest rate of intolerance requiring drug cessation (13% versus 7% in each of the fluconazole and voriconazole groups). Fluconazole conferred overall savings per patient of 26% over posaconazole and 13% over voriconazole. Monte Carlo simulation demonstrated a mean cost saving with fluconazole of AU$8430 per patient (95% CI AU$5803-AU$11 054) versus posaconazole and AU$3681 per patient (95% CI AU$990-AU$6319) versus voriconazole. One-way sensitivity analyses confirmed the robustness of the model. Conclusions: This is the first study to show that, in the setting of consolidation therapy for AML, fluconazole is the most cost-effective approach to antifungal prophylaxis compared with posaconazole or voriconazole.
SponsorThis study was supported by internal funding.
Languageen
PublisherOxford University Press
SubjectAML
Antifungals
Modelling
TitlePharmacoeconomic evaluation of fluconazole, posaconazole and voriconazole for antifungal prophylaxis in patients with acute myeloid leukaemia undergoing first consolidation chemotherapy
TypeArticle
Pagination1669-1678
Issue Number7
Volume Number68
dc.accessType Open Access


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record