Pharmacoeconomics of Empirical Antifungal Use in Febrile Neutropenic Hematological Malignancy and Hematopoietic Stem Cell Transplant Patients

Stuart J Turner; Sharon CA Chen; Monica A Slavin; David CM Kong


Expert Rev Pharmacoeconomics Outcomes Res. 2013;13(2):227-235. 

In This Article


In conclusion, prescribing the most cost-effective empirical antifungal agent remains a challenge, given the limited clinical and pharmacoeconomic data available. Existing studies have methodological limitations, which makes generalization of study outcomes challenging. Drug acquisition cost may not always be the best guide in choosing the most cost-effective antifungal agent for empiric antifungal therapy. Understanding other cost drivers for empirical treatment of IFI is important to clinical decision-making. This includes consideration of the overall treatment cost, especially in the instance when there are significant failure rates to first-line therapy. Furthermore, there is a need to use an objective, comprehensive outcome measure(s) that allows for comparison across studies. The use of mixed treatment comparison of randomized controlled studies to generate data should also be explored. Consensus on appropriate outcome measures and both clinically and economically significant adverse events need to be agreed upon to allow for clearer guidance to be provided on the most cost-effective approach in empiric antifungal therapy.