Barbara D Alexander, Melissa Johnson, Mark Bresnik, Vamshi Ruthwik Anupindi, Lia Pizzicato, Mitchell DeKoven, Belinda Lovelace, Craig I Coleman
{"title":"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。","authors":"Barbara D Alexander, Melissa Johnson, Mark Bresnik, Vamshi Ruthwik Anupindi, Lia Pizzicato, Mitchell DeKoven, Belinda Lovelace, Craig I Coleman","doi":"10.1093/ofid/ofae747","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Early antifungal initiation in invasive aspergillosis (IA) is recommended. Changing antifungals occurs for a myriad of reasons but associated costs are unclear.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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, <i>P</i> < .001) and costs were higher (Δ = $65,149, <i>P</i> < .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).</p><p><strong>Conclusions: </strong>Changing antifungals was associated with longer hospital stays and costs and higher all-cause costs over 12-months.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae747"},"PeriodicalIF":3.8000,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739793/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association Between the Need to Change Initial Antifungal Therapy and Treatment Costs in Patients With Invasive Aspergillosis.\",\"authors\":\"Barbara D Alexander, Melissa Johnson, Mark Bresnik, Vamshi Ruthwik Anupindi, Lia Pizzicato, Mitchell DeKoven, Belinda Lovelace, Craig I Coleman\",\"doi\":\"10.1093/ofid/ofae747\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Early antifungal initiation in invasive aspergillosis (IA) is recommended. Changing antifungals occurs for a myriad of reasons but associated costs are unclear.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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, <i>P</i> < .001) and costs were higher (Δ = $65,149, <i>P</i> < .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).</p><p><strong>Conclusions: </strong>Changing antifungals was associated with longer hospital stays and costs and higher all-cause costs over 12-months.</p>\",\"PeriodicalId\":19517,\"journal\":{\"name\":\"Open Forum Infectious Diseases\",\"volume\":\"12 1\",\"pages\":\"ofae747\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-12-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739793/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Forum Infectious Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ofid/ofae747\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Forum Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ofid/ofae747","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Association Between the Need to Change Initial Antifungal Therapy and Treatment Costs in Patients With Invasive Aspergillosis.
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.
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.
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