Cost Effectiveness of Itraconazole in the Prophylaxis of Invasive Fungal Infections

Background: Invasive fungal infections in neutropenic patients treated forAbstract haematological malignancies are associated with a high mortality rate and, therefore, require early treatment. As the diagnosis of invasive fungal infections is difficult, effective antifungal prophylaxis is desirable. So far, fluconazole has been the most commonly used. Objective: To assess the cost effectiveness of itraconazole compared with both fluconazole and no prophylaxis for the prevention of invasive fungal infections in haematological patients, mean age 51 years, in Germany and The Netherlands. Study design: We designed a probabilistic decision model to fully incorporate the uncertainty associated with the risk estimates of acquiring an invasive fungal infection. These risk estimates were extracted from two meta-analyses, evaluating the effectiveness of fluconazole and itraconazole and no prophylaxis. The per-spective of the analysis was that of the healthcare sector; only medical costs were taken into account. All costs were reported in €, year 2004 values. Cost effectiveness was expressed as net costs per invasive fungal infectio