侵袭性曲霉病患者初始抗真菌治疗调整需求与治疗费用之间的关联
Association Between the Need to Change Initial Antifungal Therapy and Treatment Costs in Patients With Invasive Aspergillosis.
作者信息
Alexander Barbara D, Johnson Melissa, Bresnik Mark, Anupindi Vamshi Ruthwik, Pizzicato Lia, DeKoven Mitchell, Lovelace Belinda, Coleman Craig I
机构信息
Infectious Diseases Division, Duke University, Durham, North Carolina, USA.
F2G, Inc., Princeton, New Jersey, USA.
出版信息
Open Forum Infect Dis. 2024 Dec 20;12(1):ofae747. doi: 10.1093/ofid/ofae747. eCollection 2025 Jan.
BACKGROUND
Early antifungal initiation in invasive aspergillosis (IA) is recommended. Changing antifungals occurs for a myriad of reasons but associated costs are unclear.
METHODS
US claims data for adults admitted for IA were identified from 10/1/2015 to 11/30/2022. Patients were stratified by those who did and did not change antifungal therapy. Adjusted all-cause healthcare utilization and costs/patient during index hospitalization and at 1, 6, and 12-months after the index date between the cohorts that did and did not change antifungal therapy were compared.
RESULTS
Among 1,192 IA patients, 707 (59.3%) changed their initial antifungal therapy over follow-up. The index hospital length of stay was longer (Δ = 6 days, < .001) and costs were higher (Δ = $65,149, < .001) in the change vs. no change cohort. Median 1, 6, and 12-months all-cause costs were higher in patients changing antifungal therapy vs. not (Δ = $90,938-$192,953).
CONCLUSIONS
Changing antifungals was associated with longer hospital stays and costs and higher all-cause costs over 12-months.
背景
建议在侵袭性曲霉病（IA）中尽早开始抗真菌治疗。更换抗真菌药物的原因有很多，但相关成本尚不清楚。
方法
从2015年10月1日至2022年11月30日确定美国IA成人住院患者的索赔数据。患者按是否更换抗真菌治疗进行分层。比较了更换和未更换抗真菌治疗的队列在索引住院期间以及索引日期后1、6和12个月的调整后全因医疗保健利用率和每位患者的成本。
结果
在1192例IA患者中，707例（59.3%）在随访期间改变了初始抗真菌治疗。与未更换队列相比，更换队列的索引住院时间更长（Δ = 6天，P <.001），成本更高（Δ = 65,149美元，P <.001）。更换抗真菌治疗的患者在1、6和12个月时的全因成本中位数高于未更换患者（Δ = 90,938 - 192,953美元）。
结论
更换抗真菌药物与更长的住院时间、成本以及12个月内更高的全因成本相关。
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