Association Between the Need to Change Initial Antifungal Therapy and Treatment Costs in Patients With Invasive Aspergillosis.

IF 3.8 4区医学 Q2 IMMUNOLOGY

Open Forum Infectious Diseases Pub Date : 2024-12-20 eCollection Date: 2025-01-01 DOI:10.1093/ofid/ofae747

Barbara D Alexander, Melissa Johnson, Mark Bresnik, Vamshi Ruthwik Anupindi, Lia Pizzicato, Mitchell DeKoven, Belinda Lovelace, Craig I Coleman

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Abstract

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, P < .001) and costs were higher (Δ = $65,149, P < .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.

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侵袭性曲霉病患者需要改变初始抗真菌治疗与治疗费用之间的关系。

背景：侵袭性曲霉病（IA）推荐早期抗真菌治疗。改变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，对美国因IA入院的成年人的索赔数据进行鉴定。患者被分为使用和不使用抗真菌治疗的患者。在指数住院期间和指数日期后1、6和12个月，比较有和没有改变抗真菌治疗的队列之间调整的全因医疗保健利用和成本/患者。结果：1192例IA患者中，707例（59.3%）在随访期间改变了最初的抗真菌治疗方案。变化组与未变化组的住院时间指数更长（Δ = 6天，P < 0.001），费用更高（Δ = 65,149美元，P < 0.001）。在接受抗真菌治疗的患者中，1、6和12个月的全因成本中位数高于未接受抗真菌治疗的患者（Δ = 90,938- 192,953美元）。结论：更换抗真菌药物与较长的住院时间和费用以及12个月内较高的全因费用有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Open Forum Infectious Diseases Medicine-Neurology (clinical)

CiteScore

6.70

自引率

4.80%

发文量

630

审稿时长

9 weeks

期刊介绍： Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.