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

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

doi:10.1093/jacamr/dlad079

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

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

Authors

Julia Jeck^{1

2}, Florian Jakobs³, Melina S Kurte², Oliver A Cornely^{1

4

5

6

7}, Florian Kron^{1

2

4

8}

Affiliations

¹ Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany.
² VITIS GmbH, Am Morsdorfer Hof 12, 50933 Cologne, Germany.
³ Department of Haematology and Stem Cell Transplantation, Faculty of Medicine and Essen University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.
⁴ Center for Integrated Oncology Cologne (CIO ABCD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 28 62, 50937 Cologne, Germany.
⁵ Clinical Trials Centre Cologne (ZKS Köln), Faculty of Medicine and University Hospital Cologne, University of Cologne, Gleueler Straße 269, 50935 Cologne, Germany.
⁶ CECAD Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Joseph-Stelzmann-Straße 26, 50931 Cologne, Germany.
⁷ Excellence Centre for Medical Mycology (ECMM), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany.
⁸ FOM University of Applied Sciences, Leimkugelstraße 6, 45141 Essen, Germany.

Abstract

Objective: Candida 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 Candida 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 Candida 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 Candida infections, of which 61% received ICU treatment (n = 442) and 29% were mechanically ventilated (n = 207). Twenty-six percent died during hospitalization (n = 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.