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Table 1 Model inputs

From: Cost-effectiveness of micafungin as an alternative to fluconazole empiric treatment of suspected ICU-acquired candidemia among patients with sepsis: a model simulation

Parameter Point estimate Range Source
Candidemia risk and mortality    
   Risk of candidemia 0.140 0.048 to 0.283 See Table S1 in Additional data file 1
   Risk of CK/CG among candidemia 0.148 0.132 to 0.361 See Table S2 in Additional data file 1
   Candidemia attributable mortality 0.4 0.2 to 0.8 Golan and colleagues [22]
   Mortality reduction with appropriate empiric therapy 0.48 0.35 to 0.65 Morrell and colleagues [12] (inverse)
Evaluation and treatment    
   Days of empiric treatment until availability of C&S results 3 2 to 4 Assumption
   Total duration of appropriate treatment (days) 10 7 to 14 Guideline recommendations of 14 days reduced to 10 days to account for mortalities
   Days of antibiotic treatment if switched from MIC to FLU in response to C&S 7 4 to 10 Total duration of appropriate treatment – Days of empiric treatment until availability of C&S results
   Days of antibiotic treatment if switched from FLU to MIC in response to C&S 10 7 to 14 Total duration of appropriate treatment
Cost of antibiotics    
   MIC ($/100 mg daily IV) $100 $80 to 120 WHC Pharmacy
   FLU ($/400 mg daily IV) $12 $10 to 14 WHC Pharmacy
   FLU ($/400 mg single loading dose on day 1) $12 $10 to 14 WHC Pharmacy
Life expectancy, QALY adjustment and lifetime costs    
   Median age (years) 64 48 to 80 Median from Table S1 in Additional data file 1; range is +/- 25% median
   Life expectancy (years) 17.4 13.0 to 21.4 Actuarial tables from the US Social Security Administration [24]; for men; range is +/-25%
   Relative risk of death 0.51 0.49 to 0.59 Quartin and colleagues [25]
   QALY adjustment 0.64 0.44 to 0.80 Fowler and colleagues [26], and Davies and colleagues [27]
   Age-specific annual healthcare costs/survivor in 2001 $US* $16,446 $12,335 to $20,558 Shorr and colleagues [29]
   Annual discount rate 3% 0 to 6% Weinstein and colleagues [19]
  1. *Inflating to 2008 $US using the medical component of the consumer price index resulted in $22,080, 95% confidence interval $16,588 to $27,601.
  2. CG = Candida glabrata; CK = Candida krusei; C&S = culture and sensitivity; FLU = fluconazole; iv = intravenous; MIC = micafungin; QALY = quality-adjusted life year.
  3. WHC = Washington Hospital Center, Washington, DC, USA
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