Table 2. Unit Costs for Treatment of Fungal Infections and Antifungal Drugs.
| Cost Variable | Cost in 2011 US$ |
|---|---|
| Treatment of presumptive, probable, and proven IFIs | |
| Invasive Aspergillusa | $79,358b |
| Invasive Candidaa | $29,419b |
| Other IFIa | $15,001b |
| Alternative value for treatment costsc | $48,011d |
| Planned prophylaxise | |
| Voriconazole (oral) | |
| Aged <12 years branded (generic) | $67.31 ($36.72)/dayf |
| Aged ≥12 years branded (generic) | $134.63 ($73.44)/dayf |
| Fluconazole (oral) | |
| Aged < 12 years | $7.11/dayf |
| Aged ≥12 years | $16.11/dayf |
| Empirical antifungal therapyh | |
| Amphotericin B—lipid formulation (IV) | $761.79/dayf |
| Voriconazole (IV) | $149.54/dayf |
| Itraconazole (IV) | $7.71/dayf |
| Caspofungin (IV) | $302.01/dayf |
| Fluconazole (IV) | $26.65/dayf |
| Micafungin (IV) | $93.50/dayf |
| Supplemental Prophylaxisg | |
| Amphotericin B—lipid formulation (IV) | $756.19/dayf |
| Voriconazole (oral) branded (generic) | $128.59 ($70.14)/dayf |
| Itraconazole (oral) | $20.89/dayf |
| Caspofungin (IV) | $307.24/dayf |
| Fluconazole (oral) | $15.59/dayf |
| Micafungin (IV) | $93.50/dayf |
IFI = invasive fungal infection; IV = intravenous.
Costs include incremental hospitalization costs for patients with IFI compared with those without IFI with the same underlying diagnosis.
Data source: Collins et al., 2008.13
A single average cost was assumed for all IFI types for the alternative IFI treatment cost scenario based on the value used in the O'Sullivan and colleagues14 cost-effectiveness analysis.
Data source: O'Sullivan et al., 2009.14
Dosing for planned prophylaxis was taken from the BMT CTN 0101 clinical trial protocol: 400 mg/day for those aged ≥ 12 years; 200 mg/day for those aged < 12 years and weighing ≥ 20 kg; 100 mg/day for those aged < 12 years and weighing < 20 kg.
Data source: Red Book online, 2011.15
Empirical therapy was assumed to use an IV formulation and supplemental prophylaxis to use an oral formulation where possible. Dosing was based on the BMT CNT 0101 clinical trial protocol for voriconazole and fluconazole and on prescribing information for the other antifungal drugs used during the clinical trial and weighted based on the age distribution.