Posaconazole Case Study

1. Title: Cost-Benefit analysis of voriconazole versus posaconazole for antifungal prophylaxis in patients with acute myeloid leukemia undergoing induction chemotherapy in Australia
2. Research by: Al-Badriyeh D, Slavin M, Liew D, et al. Pharmacoeconomic evaluation of voriconazole versus posaconazole for antifungal prophylaxis in acute myeloid leukaemia. Journal of Antimicrobial Chemotherapy. 2010; 65(5): 1052-61
3. Condensation and Commentary by: Hanna Yahya Mohamed, Final year pharmacy student, Qatar University
4. Condensation of the Research:
Purpose of the study
To evaluate the clinical and economic outcomes of voriconazole and posaconazole when they used as antifungal prophylaxis in acute myeloid leukemia (AML) patients undergoing induction
Since 2002, voriconazole, a triazole antifungal agent, was used in practice as a prophylaxis drug against IFI in neutropenic patients with AML (2,3,8), deposit that there was no large randomized studies performed - at that time- to assess its efficacy in preventing IFI in these specific patients (2,8). On the other hand, posaconazole, which was introduced in the market in 2006, was shown to reduce the incidence of IFI in patients who went through induction chemotherapy for AML (8,9). For example: Cornely et al. showed that posaconazole prophylaxis is superior to fluconazole or itraconazole in reducing IFI incidence (occurrence rate is 2% in posaconazole arm versus 8% in fluconazole/itraconazole group, p-value <0.001) and mortality rate (P=0.04) during AML chemotherapy induction phase (10). However, studies that evaluate the efficacy of posaconazole compared with voriconazole are yet not performed. Thus, there is a gap of knowledge in determining if posaconazole will be also superior to voriconazole (the standard line) in preventing IFI in AML patients. Moreover, there is no pharmacoeconomic study preformed to compare these agents for that
provided the first pharmacoeconomic study that investigates the clinical effectiveness and cost associated of voriconazole versus posaconazole as a prophylaxis from IFI in patients with AML induction chemotherapy (3). The purpose of this work was to evaluate the direct healthcare cost and clinical effectiveness of each drug in the primary prevention of IFI in AML patients undergoing chemotherapy (3). Based on the objective and the perspective of the study, cost-benefit analysis was suitable in this study because it allow for comparing multiple outcomes (like discontinuation of the therapy, therapeutic success …etc) in single