PIN49 - THE COST-EFFECTIVENESS ANALYSIS OF ANIDULAFUNGIN VERSUS CASPOFUNGIN FOR CANDIDEMIA AND INVASIVE CANDIDIASIS TREATMENT: AN EXPERIENCE FROM IRAN

Abstract

Candidemia and invasive candidiasis is one of the life-threatening infection disease. On the other hand, the treatment is costly for patients and health system. Echinocandins have proven to be effective in aforementioned diseases as first line treatment. The aim of this study is to evaluate the cost-effectiveness of anidulafungin versus caspofungin form Iranian health care perspective. A hybrid decision tree/Markov model was developed from payer perspective to forecast the consequences of treatment. The population of study was non-neutropenic adult patients with candidemia or invasive candidiasis. The time horizon of the study was 2 weeks for decision tree and life expectancy has been considered for the Markov’s part of the model. Treatment success and outcome were based on previously published network analysis. Direct medical costs per patient obtained from tariff book. All monetary value presented in USD (1 USD$=32771 Rials). The effectiveness was measured as QALY. The probability of drug toxicities, life expectancy statistics and utility were extracted from published literatures. Utility and cost discounted at 3.5%. The results represented in incremental cost-effectiveness ratio. Univariate deterministic and probabilistic sensitivity analysis was applied to demonstrate model robustness. For a course of treatment, total cost was around $11016 for anidulafungin and $9220 for caspofungin. anidulafungin leads to gain 9.345 QALY and caspofungin leads to gain 8.809 QALY. ICER of anidulafungin versus caspofungin was $3349 per QALY gained. Sensitivity analyzes showed the results` robustness and the main actor is drug prices, especially anidulafungin. To consider Iran ‘s GDP per capita (USD$ 4957 in 2015), anidulafungin is a cost-effectiveness alternative for candidemia/ invasive candidiasis treatment.