Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Click here to sign up for SAGE Journal Email Alerts today!

Sign In to gain access to subscriptions and/or personal tools.
Medical Decision Making
This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Scharfstein, J. A.
Right arrow Articles by Freedberg, K. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Scharfstein, J. A.
Right arrow Articles by Freedberg, K. A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Other

The Cost-Effectiveness of Fluconazole Prophylaxis against Primary Systemic Fungal Infections in AIDS Patients

Julie A. Scharfstein, ScD, MSc

A. David Paltiel, PhD

Kenneth A. Freedberg, MD, MSc

Objective. To project the cost-effectiveness of fluconazole for prophylaxis against AIDS-related primary systemic fungal infections. Design. A Markov model with data from the literature. Patients. Hypothetical cohort of 100,000 AIDS patients. Intervention. No prophylaxis, and fluconazole prophylaxis beginning when a patient's CD4 count declined to below 200/mm3, below 100/mm 3, or below 50/mm3. Results. The no-pro phylaxis policy was associated with a discounted life expectancy of 28.20 months and direct medical costs of $36,100 per person. The <200/mm3 strategy increased costs to $40,500 and life expectancy to 28.42 months, producing a ratio of $240,000 per year of life saved (YLS). Compared with the no-prophylaxis and <200/mm3 policies, the intermediate alternatives were less economically efficient. A reduction in flucona zole's cost from $206 to $80 decreased the ratio to $50,000 for the <200/mm3 strategy. Doubling fungal infection incidence lowered this ratio to $96,000/YLS. Conclusions. Fluconazole prophylaxis is unlikely to be cost-effective unless its cost is lowered, or it is focused on patients in regions endemic for fungal infections. Key words: fluconazole; prophylaxis; AIDS; cost-effectiveness; Markov model. (Med Decis Making 1997;17: 373-381)

Medical Decision Making, Vol. 17, No. 4, 373-381 (1997)
DOI: 10.1177/0272989X9701700402
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 Med Decis MakingHome page
J. Hornberger, M. Holodniy, K. Robertus, M. Winnike, E. Gibson, and E. Verhulst
A Systematic Review of Cost-Utility Analyses in HIV/AIDS: Implications for Public Policy
Med Decis Making, December 1, 2007; 27(6): 789 - 821.
[Abstract] [PDF]

Home page
 Med Decis MakingHome page
T. O. Tengs and T. H. Lin
A Meta-Analysis of Utility Estimates for HIV/AIDS
Med Decis Making, December 1, 2002; 22(6): 475 - 481.
[Abstract] [PDF]

Home page
 InterfacesHome page
J. G. Kahn, M. L. Brandeau, and J. Dunn-Mortimer
OR Modeling and AIDS Policy: From Theory to Practice
Interfaces, May 1, 1998; 28(3): 3 - 22.
[Abstract] [PDF]