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Voriconazole Clears Aspergillosis Infections With Less Overall Expense than Amphotericin: Presented at ICAAC
By Ed Susman
CHICAGO, IL -- September 24, 2003 -- Researchers found that treating patients with a new antifungal agent -- voriconazole -- results in lower overall cost than treatment with amphotericin B, even though the new drug is more expensive.
In a presentation here September 18th at the 43rd Annual Interscience Conference on Antimicrobial Agents and Chemotherapy Thomas Patterson, MD, Professor of Medicine, University of Texas Health Science Center, San Antonio, Texas, noted that use of voriconazole also appears to be more effective than the standard treatment of invasive aspergillosis.
"For patients whose immune systems are compromised by cancer chemotherapy or organ and bone-marrow transplants, invasive aspergillosis can be fatal," said Dr. Patterson. "Physicians need to understand that the type of therapy selected for first line [treatment] impacts the patient's chance of survival."
Dr. Patterson said that after 12 weeks, total costs for 144 patients randomized to voriconazole were $783,184 U.S. ($581,008 for the drug itself and $202,176 for other licensed anti-fungal therapy). The 133 patients who were first assigned to receive amphotericin B had a total drug cost of $826,005 ($31,677 U.S. for the drug and $794,328 for other licensed anti-fungal therapy).
"Overall per patient cost was $772 less for those randomized to primary therapy with voriconazole than for those randomized to initial therapy with amphotericin B," Dr. Patterson reported.
In addition, he noted, initial treatment with voriconazole led to significantly better outcomes for patients compared with those initially treated with amphotericin B. The voriconazole patients achieved a 53% success rate, compared with a 32% with amphotericin B
Further, 36% of voriconazole patients required other anti-fungal treatment compared with 80% of patients treated with amphotericin B, Dr. Patterson noted.
"The cost of antifungal therapy must include both the total drug costs as well as the potential for a positive outcome," said co-author James Lewis, PharmD, infectious diseases pharmacy specialist, University of Texas Health Science Center. "The reduced drug cost seen in the study is influenced by the improved efficacy and tolerability of voriconazole when compared to other therapies."
Total drug cost per positive outcome (treatment success) was $10,305 for voriconazole and $19,667 for amphotericin B.
This study was supported by Pfizer, Inc.
[Study title: Economic Advantage of Voriconazole (VRC) for Primary Treatment of Invasive Aspergillosis Compared to Conventional Amphotericin B (CAB). Abstract A-1359]
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