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المؤلفHeng, Siow-Chin
المؤلفSlavin, Monica A.
المؤلفAl-Badriyeh, Daoud
المؤلفKirsa, Sue
المؤلفSeymour, John F.
المؤلفGrigg, Andrew
المؤلفThursky, Karin
المؤلفBajel, Ashish
المؤلفNation, Roger L.
المؤلفKong, David C. M.
تاريخ الإتاحة2024-04-30T05:47:45Z
تاريخ النشر2013
اسم المنشورJournal of Antimicrobial Chemotherapy
المصدرScopus
المعرّفhttp://dx.doi.org/10.1093/jac/dkt068
الرقم المعياري الدولي للكتاب3057453
معرّف المصادر الموحدhttp://hdl.handle.net/10576/54478
الملخصBackground: 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.
راعي المشروعThis study was supported by internal funding.
اللغةen
الناشرOxford University Press
الموضوعAML
Antifungals
Modelling
العنوانPharmacoeconomic evaluation of fluconazole, posaconazole and voriconazole for antifungal prophylaxis in patients with acute myeloid leukaemia undergoing first consolidation chemotherapy
النوعArticle
الصفحات1669-1678
رقم العدد7
رقم المجلد68
dc.accessType Open Access


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