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基于德国念珠菌病疾病成本研究的瑞扎芬净使用成本节约的卫生经济模型。

Health-economic modelling of cost savings due to the use of rezafungin based on a German cost-of-illness study of candidiasis.

作者信息

Jeck Julia, Jakobs Florian, Kurte Melina S, Cornely Oliver A, Kron Florian

机构信息

Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany.

VITIS GmbH, Am Morsdorfer Hof 12, 50933 Cologne, Germany.

出版信息

JAC Antimicrob Resist. 2023 Jun 19;5(3):dlad079. doi: 10.1093/jacamr/dlad079. eCollection 2023 Jun.

Abstract

OBJECTIVE

species are responsible for fungal diseases and the development of nosocomial bloodstream infections. Treatment is resource-intensive and economically challenging for healthcare systems. Cost analyses of drugs against candidiasis, such as rezafungin, are thus of great interest to healthcare payers.

METHODS

We conducted a cost-of-illness study of patients with infections based on real-word data of the Department I of Internal Medicine, University Hospital Cologne (Germany) between 2016 and 2021. Health-economic parameters were analysed to describe the economic impact of infections. Potential cost savings due to the administration of rezafungin were modelled for patients with invasive candidiasis or candidaemia based on a 5 day reduction of ICU length of stay (LOS) shown by the STRIVE study.

RESULTS

We found 724 cases (652 patients) with infections, of which 61% received ICU treatment ( = 442) and 29% were mechanically ventilated ( = 207). Twenty-six percent died during hospitalization ( = 185). Median LOS was 25 and 15 days, on normal wards and ICU, respectively. Median total treatment costs per case accounted for €22 820. Based on the ICU LOS reduction, the retrospective model showed a median cost-saving potential of €7175 per hospital case with invasive candidiasis or candidaemia. Accumulated cost savings for 37 patients of €283 335 were found.

CONCLUSIONS

Treatment of candidiasis is cost intensive due to increased hospital LOS. The ICU LOS reduction rezafungin showed in STRIVE would lead to sustainable cost savings.

摘要

目的

某些菌种可引发真菌疾病及医院血流感染。治疗资源消耗大,对医疗系统而言经济负担重。因此,针对念珠菌病的药物(如瑞扎芬净)的成本分析备受医保支付方关注。

方法

我们基于德国科隆大学医院内科一部2016年至2021年的真实数据,对念珠菌感染患者进行了疾病成本研究。分析卫生经济参数以描述念珠菌感染的经济影响。根据STRIVE研究显示的瑞扎芬净可使重症监护病房(ICU)住院时长缩短5天,对侵袭性念珠菌病或念珠菌血症患者使用瑞扎芬净可能节省的成本进行建模。

结果

我们发现724例(652名患者)念珠菌感染病例,其中61%(n = 442)接受了ICU治疗,29%(n = 207)接受了机械通气。26%(n = 185)在住院期间死亡。普通病房和ICU的中位住院时长分别为25天和15天。每例病例的中位总治疗成本为22,820欧元。基于ICU住院时长的缩短,回顾性模型显示,每例侵袭性念珠菌病或念珠菌血症医院病例的中位成本节约潜力为7175欧元。共发现37例患者累计节约成本283,335欧元。

结论

念珠菌病治疗因住院时长增加而成本高昂。STRIVE研究显示瑞扎芬净可缩短ICU住院时长,这将带来可持续的成本节约。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7668/10279419/b9d211d3a284/dlad079f1.jpg

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