PIN63 COST-EFFECTIVENESS ANALYSIS OF POSACONAZOLE VERSUS VORICONAZOLE FOR THE PROPHYLAXIS OF INVASIVE FUNGAL DISEASE IN CHINA

Abstract

Invasive fungal disease (IFD) is associated with high mortality and heavy economic burden. Triazole prophylaxis is considered a preferable strategy supported by clinical evidences. Posaconazole, a newer brand of triazole, was launched in China in its enteric-coated tablet form in 2018. This study aimed to find the proper price level of posaconazole tablet under which it will be cost-effective as well as affordable by the Chinese Basic Medical Insurance Schemes when compared with voriconazole tablet for the prophylaxis of IFD among haematological malignancies patients undergoing chemotherapy or haematopoietic stem-cell transplantation (HSCT) in China. A decision tree model and subsequent Markov model were conducted. The incidence of IFD of the two regimens were from a network meta-analysis because of the absence of head-to-head study. IFD related mortality, treatment cost, screening cost and utility were extracted from the published resources. China’ per capita GDP of 2018 (9328.4USD by exchange rate of June 11th, 2019) was applied for calculating willingness-to-pay. For chemotherapy patients, the lowest prices making posaconazole tablet’s price per tablet (100mg) cost-effective were from 35.5 USD to 37.2 USD when the willingness to pay ranged from 3 times to one time of per capita GDP, respectively. For HSCT patients, the lowest price range was from 34.6 USD to 36.1 USD. The results suggest that posaconazole tablet would have potential to be cost-effective as compared with voriconazole tablet, provided that the price is set to be reasonable.