Pharmacoeconomics of liposomal drugs: the case of amphotericin B

Liposomal formulation allows alteration of pharmacological, toxicological, and immunological response and also the bioavailability of drugs. For the antifungal drug amphotericin B (AMPHO B) such innovative pharmaceutical preparations are available in most European countries. The published documentation does not yet allow definition of the therapeutic place and equivalence to conventional AMPHO B deoxycholate (DOC)but reveals generally reduced toxicity, the most limiting factor of AMPHO B DOC therapy. Compared to AMPHO B DOC, the treatment cost of the liposomal preparations increases up to over 50 times. Therefore, critical pharmacoeconomic evaluation is needed. The hospital pharmacist is asked to take part in the drug evaluation and selection process. He is also in the best position to collect pharmacoeconomic data on indication, dosage, cost, and patient outcome. To fulfil such a mission he needs well-balanced and structured drug documentation, e.g. by the EAHP questionnaire, and also special education and training to acquire the expertise required within the therapeutic drug committee.