Objectives: The direct cost of invasive fungal disease (IFD) includes antifungal drugs as well as diagnostic tests. The aim of this study was to determine these costs. Methods: A total of 203 haematology patients were enrolled into the study and followed for a median of 556 days. Data were prospectively collected on antifungal drugs, diagnostic tests, length of stay and antibiotic usage. Results: The overall mean (IQR) cost of care per patient (using UK-based reference costs) was £88911 (45339-121594), £61509 (39748-78383), £50332 (23037-72057) and £34075 (19928-43900) for proven/probable IFD, possible IFD, not classified and no evidence of IFD, respectively (P<0.001). The attributable cost of IFD was £54836. Inpatient hospital stay accounted for nearly 74% of costs. In proven/probable IFD inpatient care, antifungals, antibiotics and IFD status accounted for 68%, 25%, 5% and 2%, respectively, compared with 85%, 11%, 2% and 2%, respectively, for no IFD (P<0.001). Among the allogeneic transplant patients, £36914 (60%) of the total cost (£60917) was used during the first 100 days. Conclusions: IFD was associated with longer length of stay and higher total overall cost of care, with attributable costs greater than £50000 per case of IFD. Costs for inpatient stay far outstrip the cost of antifungal agents.
Bibliographical noteFunding Information:
Gilead Sciences provided funds to Aquarius Population Health to support this project. Aquarius Population Health has a Gilead Fellowship Grant for HIV and Gilead has funded other work on liposomal amphotericin B and HIV. E. J. A. is an employee of Aquarius Population Health and A. E. and Z. S. were contracted by Aquarius Population Health for this project. M. M. C. and A. P. acknowledge honoraria from Gilead Sciences for lectures, advisory boards and conference sponsorships. E. J. A. reports funding from Aquarius Population Health (from Gilead) to conduct this study and has received grants and personal fees from Gilead, outside the submitted work. Z. S., R. H. and A. E. report personal fees from Aquarius Population Health during the conduct of the study. However, none of these authors played any decision-making role in this research.
This work was supported by Gilead Sciences, Pfizer and Merck Sharp & Dohme (MSD) Limited who provided unrestricted educational grants for the project.
© The Author 2014.
- Attributable cost
- Diagnostic tests
- Length of stay