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COST-EFFECTIVENESS ANALYSIS OF ANIDULAFUNGIN COMPARED TO OTHER ECHINOCANDINS MEDICATIONS FOR THE TREATMENT OF INVASIVE CANDIDA INFECTIONS IN VIETNAM
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Abstract
Background: Echinocandins, a recently developed injectable antifungal drug, have demonstrated efficacy and safety in numerous clinical studies, leading to their approval for the treatment of invasive Candida infections. However, the cost-effectiveness of this drug requires thorough evaluation, particularly in countries with limited healthcare resources, such as Vietnam. Research methods: Using a decision-tree model, our analysis simulates the invasive Candida treatment process, incorporating data sourced from medical literature and insights obtained through expert interviews, all considered from the perspective of the Vietnamese healthcare payer. Results: In the base-case result, from the perspective of the health insurance payer, anidulafungin exhibited a treatment cost of 95.87 million VND, lower than caspofungin (125.20 million VND) and amphotericin B lipid complex (ABLC) (151.02 million VND), but higher than fluconazole (66.69 million VND), amphotericin B (55.89 million VND), and voriconazole (53.52 million VND). Simultaneously, anidulafungin demonstrated the highest effectiveness with 5.34 Life Year Gains (LYG), surpassing other interventions by 0.34 – 1.28 LYG. Consequently, in comparison to caspofungin and ABLC, anidulafungin not only reduces costs but also enhances effectiveness. The incremental cost-effectiveness ratio (ICER) values of 56.97 million VND/LYG compared to fluconazole, 58.96 million VND/LYG compared to amphotericin B, and 70.13 million VND/LYG compared to voriconazole are all lower than Vietnam's per capita GDP in 2023 (101.90 million VND). Conclusion: In the real-world setting of invasive candidiasis treatment in Vietnam, anidulafungin achieved higher cost-effectiveness compared to fluconazole, amphotericin B, and voriconazole, while being dominant over caspofungin and ABLC from the Vietnamese healthcare payer perspective.
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Keywords
Echinocandins, invasive candidiasis, IC, cost-effectiveness
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