This was the first study to investigate the pharmacoeconomic impact of voriconazole versus posaconazole as antifungal prophylaxis in patients with AML. It showed that posaconazole is more cost-beneficial prophylactic agent than voriconazole. The cost per patient associated with initial prophylaxis was higher for voriconazole as compared with posaconazole. This difference in cost was mainly due to the fact that while posaconazole was only received as an oral formulation, three patients on voriconazole received intravenous (IV) formulation for the 1 month induction stage. This was demonstrated in the one-way sensitivity analysis, where changing IV doses of initial voriconazole to oral dosage form resulted in the cost of initial voriconazole to become less than that for posaconazole.
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The total cost of alternative therapies was also higher with voriconazole as compared with posaconazole. This is logical given the fact that patients receiving voriconazole as initial therapy experienced more overall switching to alternative therapies, which mean that more alternative therapy and costs were consumed. Costs of side effects that did not lead to discontinuation was not included in this study. This is not expected to change the study conclusion, however, because posaconazole has fewer reported side effects than voriconazole. Therefore, accounting for costs of all side effects associated with the two antifungals would have most likely increased the posaconazole economic advantage. These observations highlight the need for prescribers and other decision makers to consider drug acquisition costs as well as secondary costs, such as cost of therapy failure, when determining the most appropriate medication for
The total cost of alternative therapies was also higher with voriconazole as compared with posaconazole. This is logical given the fact that patients receiving voriconazole as initial therapy experienced more overall switching to alternative therapies, which mean that more alternative therapy and costs were consumed. Costs of side effects that did not lead to discontinuation was not included in this study. This is not expected to change the study conclusion, however, because posaconazole has fewer reported side effects than voriconazole. Therefore, accounting for costs of all side effects associated with the two antifungals would have most likely increased the posaconazole economic advantage. These observations highlight the need for prescribers and other decision makers to consider drug acquisition costs as well as secondary costs, such as cost of therapy failure, when determining the most appropriate medication for