{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:04:23Z","timestamp":1781568263699,"version":"3.54.5"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,7,5]],"date-time":"2018-07-05T00:00:00Z","timestamp":1530748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Amphotericin formulations, indicated for invasive fungal infections (<jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>s), vary in effectiveness, safety and costs. In Brazil, only the conventional formulation is provided by the Public Health System. The aim of this study was to perform a cost\u2010effectiveness analysis comparing conventional amphotericin B (<jats:styled-content style=\"fixed-case\">CAB<\/jats:styled-content>), liposomal amphotericin B (<jats:styled-content style=\"fixed-case\">LAB<\/jats:styled-content>) and amphotericin B lipid complex (<jats:styled-content style=\"fixed-case\">ABLC<\/jats:styled-content>). Therefore, a decision tree was developed. The model began with high\u2010risking patients on suspicion or confirmation of <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>. The analysis was conducted under the perspective of the Brazilian Public Health System. Model health states were defined according to medication use and clinical evolution. Clinical efficacy (cure) and transition probabilities were derived from the literature. Resource use was estimated from Brazilian data. Time horizon followed the maximum treatment time determined in the patient information leaflets (3 or 6\u00a0weeks). One\u2010way and probabilistic\u2010sensitivity analyses were conducted. The conventional formulation was the most cost\u2010effective. No dominance was observed; however, high incremental cost\u2010effectiveness ratios were obtained for <jats:styled-content style=\"fixed-case\">LAB<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">USD<\/jats:styled-content> 313\u00a0130) and <jats:styled-content style=\"fixed-case\">ABLC<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">USD<\/jats:styled-content> 1\u00a0711\u00a0280). Sensitivity analyses demonstrated the robustness of the results. <jats:styled-content style=\"fixed-case\">CAB<\/jats:styled-content> is the most cost\u2010effective treatment, followed by <jats:styled-content style=\"fixed-case\">LAB<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ABLC<\/jats:styled-content>. Although <jats:styled-content style=\"fixed-case\">CAB<\/jats:styled-content> presents critical safety aspects, the high acquisition costs of the other formulations prevent their large\u2010scale use in Brazil.<\/jats:p>","DOI":"10.1111\/myc.12801","type":"journal-article","created":{"date-parts":[[2018,6,12]],"date-time":"2018-06-12T11:35:26Z","timestamp":1528803326000},"page":"754-763","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Cost\u2010effectiveness of amphotericin B formulations in the treatment of systemic fungal infections"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9723-584X","authenticated-orcid":false,"given":"Helena Hiemisch Lobo","family":"Borba","sequence":"first","affiliation":[{"name":"Pharmaceutical Sciences Postgraduate Research Programme Federal University of Paran\u00e1  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laiza Maria","family":"Steimbach","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Postgraduate Research Programme Federal University of Paran\u00e1  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9701-2002","authenticated-orcid":false,"given":"Bruno Salgado","family":"Riveros","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Postgraduate Research Programme Federal University of Paran\u00e1  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4262-8608","authenticated-orcid":false,"given":"Fernanda Stumpf","family":"Tonin","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Postgraduate Research Programme Federal University of Paran\u00e1  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0102-2995","authenticated-orcid":false,"given":"Vinicius Lins","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Postgraduate Research Programme Federal University of Paran\u00e1  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Aline de Queiros","family":"Bagatim","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Postgraduate Research Programme Federal University of Paran\u00e1  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisele","family":"Balan","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Postgraduate Research Programme Federal University of Paran\u00e1  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7049-4363","authenticated-orcid":false,"given":"Roberto","family":"Pontarolo","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Postgraduate Research Programme Federal University of Paran\u00e1  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4460-4044","authenticated-orcid":false,"given":"Astrid","family":"Wiens","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Postgraduate Research Programme Federal University of Paran\u00e1  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,7,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1155\/1999\/139326"},{"key":"e_1_2_7_3_1","first-page":"226","article-title":"Fungal infections: a growing threat","volume":"111","author":"Dixon 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Diretrizes Metodol\u00f3gicas. Estudos de Avalia\u00e7\u00e3o Econ\u00f4mica de Tecnologias em Sa\u00fade.Secretaria de ci\u00eancia tecnologia e insumos estrat\u00e9gicos departamento de ci\u00eancia e tecnologia.2009."},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12585"},{"key":"e_1_2_7_20_1","unstructured":"ABELCET\u00ae. ABELCET\u00ae (complexo lip\u00eddico de anfotericina B).Teva farmac\u00eautica Ltda.2016."},{"key":"e_1_2_7_21_1","unstructured":"ANFORICINB\u00ae. ANFORICIN B\u00ae (anfotericina B).Crist\u00e1lia prod qu\u00edm farm Ltda.2014."},{"key":"e_1_2_7_22_1","unstructured":"AmBisome\u00ae. AmBisome\u00ae (anfotericina B lipossomal).United medical LTDA.2016."},{"key":"e_1_2_7_23_1","unstructured":"Brazilian Ministry of Health.C\u00e2mara de regula\u00e7\u00e3o do mercado de medicamentos\u2010 CMED. Available from:http:\/\/portal.anvisa.gov.br\/listas-de-precos. 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