Reference

Caspofungin versus amphotericin B for candidemia: A pharmacoeconomic analysis

All Rights Reserved. Caspofungin versus amphotericin B for candidemia: A pharmacoeconomic analysis. Wingard, John R.; Wood, Craig A.; Sullivan, Elizabeth; Berger, Marc L.; Gerth, William C.; Mansley, Edward C. (University of Florida College of Medicine, Gainesville, FL, USA). Clinical Therapeutics, 27(6), 960-969 (English) 2005 Excerpta Medica, Inc. CODEN: CLTHDG. ISSN: 0149-2918. DOCUMENT TYPE: Journal CA Section: 1 (Pharmacology) Section cross-reference(s): 14, 20 Background: In a randomized, comparative, clin. trial, caspofungin was found to be as effective as amphotericin B deoxycholate (ampho B) for treating candidemia (favorable outcomes in 71.7% and 62.8% of patients, resp.) and exhibited a generally better safety profile, particularly with respect to impaired renal function (IRF) (P = 0.02). Objective: The goal of this study was to examine whether cost savings generated from the reduced rates of IRF obsd. in the clin. trial would be enough to offset the higher acquisition cost of caspofungin relative to ampho B. Methods: We developed an economic model in which 100 hypothetical patients with candidemia were treated with caspofungin or ampho B. Rates of IRF and duration of drug therapy were taken from the clin. trial. Information on the cost of treating IRF was obtained through a search of MEDLINE using the terms amphotericin and cost, amphotericin and resource, amphotericin and hospital, and amphotericin and toxicity; and the medical subject headings kidney failure, acute/drug therapy; kidney failure, acute/epidemiol.; kidney failure, acute/etiol.; kidney/drug effects; cost of illness; costs and cost anal.; kidney failure, acute, and economics; and kidney failure, acute/economics. In addn., the Web site www.doctorfungus.com was searched for relevant refs., and the Merck publication alert system was used. 58501-21-6 and 179463-17-3 which are cas registry numbers of substances are two of reagents here. Antifungal drug costs were estd. using data from IMS Health. Costs were reported in year-2003 US dollars. Results: In the base case, the model projected that using caspofungin instead of ampho B would result in substantially lower treatment costs for IRF, which would more than offset the higher drug acquisition cost (cost-offset percentage, 122%), leading to a net mean savings of $758.60 per patient. These results were not very sensitive to the difference in daily drug cost, but were sensitive to the mean cost attributable to treating IRF. As that varied, the cost-offset percentage varied from 61% (substantial cost offset) to 183% (cost savings). Conclusions: The results of this economic model suggest that, based only on differences in drug acquisition cost and renal toxicity, the use of caspofungin instead of ampho B in patients with candidemia may be a cost-saving strategy from the perspective of a hospital. .

Effects of caspofungin (MK-0991) and anidulafungin (LY303366) on phagocytosis, oxidative burst and killing of Candida albicans by human phagocytes

Effects of caspofungin (MK-0991) and anidulafungin (LY303366) on phagocytosis, oxidative burst and killing of Candida albicans by human phagocytes. Frank, U.; Greiner, M.; Engels, I.; Daschner, F. D. (Institute of Environmental Medicine and Hospital Epidemiology, Freiburg University Hospital, Freiburg 79106, Germany). European Journal of Clinical Microbiology & Infectious Diseases, 23(9), 729-731 (English) 2004 Springer GmbH. CODEN: EJCDEU. ISSN: 0934-9723. DOCUMENT TYPE: Journal CA Section: 1 (Pharmacology) The objective of the present study was to investigate the influence of the new echinocandins caspofungin (MK-0991) and anidulafungin (LY303366) on human phagocytes. Phagocytosis, oxidative burst and intracellular killing of Candida albicans were analyzed by flow cytometry. Neither caspofungin nor anidulafungin significantly influenced phagocytosis. Only caspofungin significantly influenced oxidative burst after 15 min of incubation (P<0.05). Both caspofungin and anidulafungin improved intracellular killing rates of C. albicans after 2 h of incubation (42.4 and 43.2, resp., compared to 37. 166663-25-8 and 179463-17-3 which are cas registry numbers of substances are two of reagents here.9 in controls; P<0.05). In conclusion, caspofungin significantly improves oxidative burst and intracellular killing, which may be advantageous for clin. therapy. .