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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Cost-effectiveness analysis of anidulafungin in the treatment of candidaemia</title><author><name sortKey="Auzinger, G" sort="Auzinger, G" uniqKey="Auzinger G" first="G" last="Auzinger">G. Auzinger</name><affiliation><nlm:aff id="I1">King's College Hospital, London, UK</nlm:aff></affiliation></author><author><name sortKey="Playford, G" sort="Playford, G" uniqKey="Playford G" first="G" last="Playford">G. Playford</name><affiliation><nlm:aff id="I2">Princess Alexandra Hospital, Brisbane, Australia</nlm:aff></affiliation></author><author><name sortKey="Graham, C" sort="Graham, C" uniqKey="Graham C" first="C" last="Graham">C. Graham</name><affiliation><nlm:aff id="I3">RTI Health Solutions, Durham, NC, USA</nlm:aff></affiliation></author><author><name sortKey="Narula, H" sort="Narula, H" uniqKey="Narula H" first="H" last="Narula">H. Narula</name><affiliation><nlm:aff id="I3">RTI Health Solutions, Durham, NC, USA</nlm:aff></affiliation></author><author><name sortKey="Charbonneau, C" sort="Charbonneau, C" uniqKey="Charbonneau C" first="C" last="Charbonneau">C. Charbonneau</name><affiliation><nlm:aff id="I4">Pfizer International Operations, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Weinstein, D" sort="Weinstein, D" uniqKey="Weinstein D" first="D" last="Weinstein">D. Weinstein</name><affiliation><nlm:aff id="I4">Pfizer International Operations, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Kantecki, M" sort="Kantecki, M" uniqKey="Kantecki M" first="M" last="Kantecki">M. Kantecki</name><affiliation><nlm:aff id="I4">Pfizer International Operations, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Schlamm, H" sort="Schlamm, H" uniqKey="Schlamm H" first="H" last="Schlamm">H. Schlamm</name><affiliation><nlm:aff id="I5">Pfizer Inc., New York, NY, USA</nlm:aff></affiliation></author><author><name sortKey="Ruhnke, M" sort="Ruhnke, M" uniqKey="Ruhnke M" first="M" last="Ruhnke">M. Ruhnke</name><affiliation><nlm:aff id="I6">Charité University Medicine, Berlin, Germany</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmc">3642880</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3642880</idno><idno type="RBID">PMC:3642880</idno><idno type="doi">10.1186/cc12025</idno><idno type="pmid">NONE</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">001155</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001155</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Cost-effectiveness analysis of anidulafungin in the treatment of candidaemia</title><author><name sortKey="Auzinger, G" sort="Auzinger, G" uniqKey="Auzinger G" first="G" last="Auzinger">G. Auzinger</name><affiliation><nlm:aff id="I1">King's College Hospital, London, UK</nlm:aff></affiliation></author><author><name sortKey="Playford, G" sort="Playford, G" uniqKey="Playford G" first="G" last="Playford">G. Playford</name><affiliation><nlm:aff id="I2">Princess Alexandra Hospital, Brisbane, Australia</nlm:aff></affiliation></author><author><name sortKey="Graham, C" sort="Graham, C" uniqKey="Graham C" first="C" last="Graham">C. Graham</name><affiliation><nlm:aff id="I3">RTI Health Solutions, Durham, NC, USA</nlm:aff></affiliation></author><author><name sortKey="Narula, H" sort="Narula, H" uniqKey="Narula H" first="H" last="Narula">H. Narula</name><affiliation><nlm:aff id="I3">RTI Health Solutions, Durham, NC, USA</nlm:aff></affiliation></author><author><name sortKey="Charbonneau, C" sort="Charbonneau, C" uniqKey="Charbonneau C" first="C" last="Charbonneau">C. Charbonneau</name><affiliation><nlm:aff id="I4">Pfizer International Operations, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Weinstein, D" sort="Weinstein, D" uniqKey="Weinstein D" first="D" last="Weinstein">D. Weinstein</name><affiliation><nlm:aff id="I4">Pfizer International Operations, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Kantecki, M" sort="Kantecki, M" uniqKey="Kantecki M" first="M" last="Kantecki">M. Kantecki</name><affiliation><nlm:aff id="I4">Pfizer International Operations, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Schlamm, H" sort="Schlamm, H" uniqKey="Schlamm H" first="H" last="Schlamm">H. Schlamm</name><affiliation><nlm:aff id="I5">Pfizer Inc., New York, NY, USA</nlm:aff></affiliation></author><author><name sortKey="Ruhnke, M" sort="Ruhnke, M" uniqKey="Ruhnke M" first="M" last="Ruhnke">M. Ruhnke</name><affiliation><nlm:aff id="I6">Charité University Medicine, Berlin, Germany</nlm:aff></affiliation></author></analytic><series><title level="j">Critical Care</title><idno type="ISSN">1364-8535</idno><idno type="eISSN">1466-609X</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Cornely, Oa" uniqKey="Cornely O">OA Cornely</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Reboli, Ac" uniqKey="Reboli A">AC Reboli</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mills, Ej" uniqKey="Mills E">EJ Mills</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sidhu, Mk" uniqKey="Sidhu M">MK Sidhu</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="abstract" xml:lang="en"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Crit Care</journal-id><journal-id journal-id-type="iso-abbrev">Crit Care</journal-id><journal-title-group><journal-title>Critical Care</journal-title></journal-title-group><issn pub-type="ppub">1364-8535</issn><issn pub-type="epub">1466-609X</issn><publisher><publisher-name>BioMed Central</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">3642880</article-id><article-id pub-id-type="publisher-id">cc12025</article-id><article-id pub-id-type="doi">10.1186/cc12025</article-id><article-categories><subj-group subj-group-type="heading"><subject>Poster Presentation</subject></subj-group></article-categories><title-group><article-title>Cost-effectiveness analysis of anidulafungin in the treatment of candidaemia</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Auzinger</surname><given-names>G</given-names></name><xref ref-type="aff" rid="I1">1</xref></contrib><contrib contrib-type="author" id="A2"><name><surname>Playford</surname><given-names>G</given-names></name><xref ref-type="aff" rid="I2">2</xref></contrib><contrib contrib-type="author" id="A3"><name><surname>Graham</surname><given-names>C</given-names></name><xref ref-type="aff" rid="I3">3</xref></contrib><contrib contrib-type="author" id="A4"><name><surname>Narula</surname><given-names>H</given-names></name><xref ref-type="aff" rid="I3">3</xref></contrib><contrib contrib-type="author" id="A5"><name><surname>Charbonneau</surname><given-names>C</given-names></name><xref ref-type="aff" rid="I4">4</xref></contrib><contrib contrib-type="author" id="A6"><name><surname>Weinstein</surname><given-names>D</given-names></name><xref ref-type="aff" rid="I4">4</xref></contrib><contrib contrib-type="author" id="A7"><name><surname>Kantecki</surname><given-names>M</given-names></name><xref ref-type="aff" rid="I4">4</xref></contrib><contrib contrib-type="author" id="A8"><name><surname>Schlamm</surname><given-names>H</given-names></name><xref ref-type="aff" rid="I5">5</xref></contrib><contrib contrib-type="author" id="A9"><name><surname>Ruhnke</surname><given-names>M</given-names></name><xref ref-type="aff" rid="I6">6</xref></contrib></contrib-group><aff id="I1"><label>1</label>King's College Hospital, London, UK</aff><aff id="I2"><label>2</label>Princess Alexandra Hospital, Brisbane, Australia</aff><aff id="I3"><label>3</label>RTI Health Solutions, Durham, NC, USA</aff><aff id="I4"><label>4</label>Pfizer International Operations, Paris, France</aff><aff id="I5"><label>5</label>Pfizer Inc., New York, NY, USA</aff><aff id="I6"><label>6</label>Charité University Medicine, Berlin, Germany</aff><pub-date pub-type="ppub"><year>2013</year></pub-date><pub-date pub-type="epub"><day>19</day><month>3</month><year>2013</year></pub-date><volume>17</volume><issue>Suppl 2</issue><supplement><named-content content-type="supplement-title">33rd International Symposium on Intensive Care and Emergency Medicine</named-content><named-content content-type="supplement-sponsor">Publication of this supplement was supported by ISICEM</named-content></supplement><fpage>P87</fpage><lpage>P87</lpage><permissions><copyright-statement>Copyright ©2013 Auzinger et al.; licensee BioMed Central Ltd.</copyright-statement><copyright-year>2013</copyright-year><copyright-holder>Auzinger et al.; licensee BioMed Central Ltd.</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><self-uri xlink:href="http://ccforum.com/content/17/S2/P87"></self-uri><conference><conf-date>19-22 March 2013</conf-date><conf-name>33rd International Symposium on Intensive Care and Emergency Medicine</conf-name><conf-loc>Brussels, Belgium</conf-loc></conference></article-meta></front><body><sec><title>Introduction</title><p>Echinocandins are recommended first-line treatment for candidaemia [<xref ref-type="bibr" rid="B1">1</xref>]. A cost-effectiveness model developed from a UK perspective examined costs and outcomes of antifungal treatment for candidaemia and other forms of invasive candidiasis based on European clinical guidelines [<xref ref-type="bibr" rid="B1">1</xref>].</p></sec><sec sec-type="methods"><title>Methods</title><p>Costs and treatment outcomes with the echinocandin anidulafungin were compared with caspofungin, micafungin, fluconazole, voriconazole and amphotericin B. The model included non-neutropenic patients aged ≥16 years with confirmed candidaemia/another form of invasive candidiasis receiving intravenous first-line treatment [<xref ref-type="bibr" rid="B2">2</xref>]. Patients were categorised as a clinical success or failure (patients with persistent/breakthrough infection); frequency data for each outcome were taken from a mixed-treatment comparison [<xref ref-type="bibr" rid="B3">3</xref>]. Successfully treated patients switched to oral therapy. Clinical failures switched to a different antifungal class. It was assumed that second-line treatment duration was equivalent to that of first-line treatment and only two lines of therapy were required to treat infection. Other inputs were all-cause 6-week mortality, cost of treatment-related adverse events (AEs) and other medical resource use costs. Life-years were calculated using a published model [<xref ref-type="bibr" rid="B4">4</xref>]. Antifungal agent-related AEs were taken from the product label/literature. Resource use was derived from the literature and discussion with clinical experts. Drug acquisition/ administration costs were taken from standard UK costing sources.</p></sec><sec sec-type="results"><title>Results</title><p>First-line anidulafungin for treatment of candidaemia was cost-effective per life-year gained versus fluconazole (incremental cost-effectiveness ratio £813). Anidulafungin was cost saving versus caspofungin and micafungin in terms of life-years gained due to lower ICU costs and a higher rate of survival combined with a higher probability of clinical success.</p></sec><sec sec-type="conclusions"><title>Conclusion</title><p>Anidulafungin was cost-effective compared with fluconazole for treatment of candidaemia and was cost saving versus other echinocandins in the UK. European guidelines recommend echinocandins as first-line treatments for candidaemia [<xref ref-type="bibr" rid="B1">1</xref>]; this model indicates that anidulafungin marries clinical effectiveness and cost-effectiveness.</p></sec></body><back><ref-list><ref id="B1"><mixed-citation publication-type="other"><name><surname>Cornely</surname><given-names>OA</given-names></name><source>Clin Microbiol Infect</source><year>2012</year><volume>17</volume><fpage>19</fpage><lpage>37</lpage><pub-id pub-id-type="pmid">23137135</pub-id></mixed-citation></ref><ref id="B2"><mixed-citation publication-type="other"><name><surname>Reboli</surname><given-names>AC</given-names></name><etal></etal><source>N Engl J Med</source><year>2007</year><volume>17</volume><fpage>2472</fpage><lpage>2482</lpage><pub-id pub-id-type="doi">10.1056/NEJMoa066906</pub-id><pub-id pub-id-type="pmid">17568028</pub-id></mixed-citation></ref><ref id="B3"><mixed-citation publication-type="other"><name><surname>Mills</surname><given-names>EJ</given-names></name><etal></etal><source>Ann Clin Microbiol Antimicrob</source><year>2009</year><volume>17</volume><fpage>23</fpage><pub-id pub-id-type="doi">10.1186/1476-0711-8-23</pub-id><pub-id pub-id-type="pmid">19558681</pub-id></mixed-citation></ref><ref id="B4"><mixed-citation publication-type="other"><name><surname>Sidhu</surname><given-names>MK</given-names></name><etal></etal><source>Curr Med Res Opin</source><year>2009</year><volume>17</volume><fpage>2049</fpage><lpage>2059</lpage><pub-id pub-id-type="doi">10.1185/03007990903072565</pub-id><pub-id pub-id-type="pmid">19575628</pub-id></mixed-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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