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Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain Azanza, Jose Ramon Ruiz Camps, Isabel Vallejo, Carlos Mensa, Josep Maertens, Johan Grau, Santiago Institut Català de la Salut [Grau S] Pharmacy Department, Hospital del Mar, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Azanza JR] Clinical Pharmacology Department, Clínica Universidad de Navarra, Pamplona. [Ruiz I] Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Vallejo C] Hematology Department, Hospital Universitario Donostia, San Sebastián. [Mensa J] Infectious Diseases Department, Hospital Clínic de Barcelona, Barcelona, Spain. [Maertens J] Hematology Department, University Hospital Gasthuisberg, Leuven, Belgium Vall d'Hebron Barcelona Hospital Campus Assistència sanitària - Cost - Catalunya Sang - Malalties Medicaments Other subheadings::Other subheadings::Other subheadings::/drug therapy HEALTH CARE::Health Care Economics and Organizations::Economics::Costs and Cost Analysis DISEASES::Hemic and Lymphatic Diseases::Hematologic Diseases GEOGRAPHICALS::Geographic Locations::Europe::Spain Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia ATENCIÓN DE SALUD::economía y organizaciones para la atención de la salud::economía::costes y análisis de costes ENFERMEDADES::enfermedades hematológicas y linfáticas::enfermedades hematológicas DENOMINACIONES GEOGRÁFICAS::localizaciones geográficas::Europa (continente)::España Anidulafungina; Cost-efectivitat; Aspergil·losi invasiva Anidulafungina; Coste-efectividad; Aspergilosis invasiva Anidulafungin, Cost-effectiveness; Invasive aspergillosis Objective: According to a recent randomized, double-blind clinical trial comparing the combination of voriconazole and anidulafungin (VOR+ANI) with VOR monotherapy for invasive aspergillosis (IA) in patients with hematologic disease or with hematopoietic stem cell transplant, mortality was lower after 6 weeks with VOR+ANI than with VOR monotherapy in a post hoc analysis of patients with galactomannan-based IA. The objective of this study was to compare the cost-effectiveness of VOR+ANI with VOR, from the perspective of hospitals in the Spanish National Health System. Methods: An economic model with deterministic and probabilistic analyses was used to determine costs per life-year gained (LYG) for VOR+ANI versus VOR in patients with galactomannan-based IA. Mortality, adverse event rates, and life expectancy were obtained from clinical trial data. The costs (in 2015 euros [€]) of the drugs and the adverse event-related costs were obtained from Spanish sources. A Tornado plot and a Monte Carlo simulation (1,000 iterations) were used to assess uncertainty of all model variables. Results: According to the deterministic analysis, for each patient treated with VOR+ANI compared with VOR monotherapy, there would be a total of 0.348 LYG (2.529 vs 2.181 years, respectively) at an incremental cost of €5,493 (€17,902 vs €12,409, respectively). Consequently, the additional cost per LYG with VOR+ANI compared with VOR would be €15,785. Deterministic sensitivity analyses confirmed the robustness of these findings. In the probabilistic analysis, the cost per LYG with VOR+ANI was €15,774 (95% confidence interval: €15,763–16,692). The probability of VOR+ANI being cost-effective compared with VOR was estimated at 82.5% and 91.9%, based on local cost-effectiveness thresholds of €30,000 and €45,000, respectively. Conclusion: According to the present economic study, combination therapy with VOR+ANI is cost-effective as primary therapy of IA in galactomannan-positive patients in Spain who have hematologic disease or hematopoietic stem cell transplant, compared with VOR monotherapy. 2021-04-22T08:19:43Z 2021-04-22T08:19:43Z 2017 2016-12-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Grau S, Azanza JR, Ruiz I, Vallejo C, Mensa J, Maertens J, et al. Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain. Clin Outcomes Res. 2016 Dec 30;Volume 9:39–47. 1178-6981 https://hdl.handle.net/11351/5897 10.2147/CEOR.S122177 28115858 000391475500002 http://hdl.handle.net/11351/5897 eng ClinicoEconomics and Outcomes Research;9 https://www.dovepress.com/cost-effectiveness-analysis-of-combination-antifungal-therapy-with-vor-peer-reviewed-article-CEOR Attribution-NonCommercial 4.0 International http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess application/pdf Dove Medical Press Scientia