Background: We evaluated the cost-effectiveness of posaconazole compared with standard azole therapy (SAT;\r\nfluconazole or itraconazole) for the prevention of invasive fungal infections (IFI) and the reduction of overall\r\nmortality in high-risk neutropenic patients with acute myelogenous leukaemia (AML) or myelodysplastic syndromes\r\n(MDS). The perspective was that of the Spanish National Health Service (NHS).\r\nMethods: A decision-analytic model, based on a randomised phase III trial, was used to predict IFI avoided, lifeyears\r\nsaved (LYS), total costs, and incremental cost-effectiveness ratio (ICER; incremental cost per LYS) over patientsââ?¬â?¢\r\nlifetime horizon. Data for the analyses included life expectancy, procedures, and costs associated with IFI and the\r\ndrugs (in euros at November 2009 values) which were obtained from the published literature and opinions of an\r\nexpert committee. A probabilistic sensitivity analysis (PAS) was performed.\r\nResults: Posaconazole was associated with fewer IFI (0.05 versus 0.11), increased LYS (2.52 versus 2.43), and\r\nsignificantly lower costs excluding costs of the underlying condition (ââ??¬6,121 versus ââ??¬7,928) per patient relative to\r\nSAT. There is an 85% probability that posaconazole is a cost-saving strategy compared to SAT and a 97%\r\nprobability that the ICER for posaconazole relative to SAT is below the cost per LYS threshold of ââ??¬30,000 currently\r\naccepted in Spain.\r\nConclusions: Posaconazole is a cost-saving prophylactic strategy (lower costs and greater efficacy) compared with\r\nfluconazole or itraconazole in high-risk neutropenic patients.
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