Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34238
Title: Costs associated with invasive Scedosporium and Lomentospora prolificans infections: a case-control study.
Austin Authors: Neoh, Chin Fen;Chen, Sharon C A;Kong, David C M;Hamilton, Kate ;Nguyen, Quoc A;Spelman, Tim;Tew, Michelle;Harvey, Emma L;Ho, Su Ann;Saunders, Natalie R;Tennakoon, Surekha;Crowe, Amy;Marriott, Debbie;Trubiano, Jason ;Slavin, Monica A
Affiliation: National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia.;Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.;Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia.
Centre for Infectious Diseases and Microbiology Laboratory Services, New South Wales Health Pathology, Westmead Hospital, Sydney, Australia.;The University of Sydney Institute of Infectious Diseases, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
The National Centre for Antimicrobial Stewardship, The Peter Doherty Institute for Infections and Immunity, Melbourne, Australia.;Centre for Medicine Use and Safety, Monash Institute of Pharmaceutical Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.;Pharmacy Department, Grampians Health-Ballarat, Melbourne, Australia.;School of Medicine, Deakin University, Geelong, Australia.
Centre for Infectious Diseases and Microbiology Laboratory Services, New South Wales Health Pathology, Westmead Hospital, Sydney, Australia.
Department of Clinical Microbiology and Infectious Diseases, St Vincent's Hospital Sydney, Sydney, Australia.;Kolling Institute, Northern Sydney Local Health District and the Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia.
Health Economics Unit, Centre for Health Policy Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
F2G Ltd, Manchester, UK.
National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia.;Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.
Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.
Department of Infectious Diseases, St Vincent's Hospital Melbourne, Melbourne, Australia.
Department of Clinical Microbiology and Infectious Diseases, St Vincent's Hospital Sydney, Sydney, Australia.
Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia.
National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia.;Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.;Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia.
Infectious Diseases
Issue Date: 3-Jan-2024
Date: 2023
Publication information: The Journal of Antimicrobial Chemotherapy 2024-01-03; 79(1)
Abstract: Little is known about the short- and long-term healthcare costs of invasive Scedosporium/Lomentospora prolificans infections, particularly in patient groups without haematological malignancy. This study investigated excess index hospitalization costs and cumulative costs of these infections. The predictors of excess cost and length of stay (LOS) of index hospitalization were determined. These estimates serve as valuable inputs for cost-effectiveness models of novel antifungal agents. A retrospective case-control study was conducted at six Australian hospitals. Cases of proven/probable invasive Scedosporium/L. prolificans infections between 2011 and 2021 (n = 34) were matched with controls (n = 66) by predefined criteria. Cost data were retrieved from activity-based costing systems and analysis was performed from the Australian public hospital perspective. All costs were presented in 2022 Australian dollars (AUD). Median regression analysis was used to adjust excess costs of index hospitalization whereas cumulative costs up to 1.5 years follow-up were estimated using interval-partitioned survival probabilities. Invasive Scedosporium/L. prolificans infections were independently associated with an adjusted median excess cost of AUD36 422 (P = 0.003) and LOS of 16.27 days (P < 0.001) during index hospitalization. Inpatient stay was the major cost driver (42.7%), followed by pharmacy cost, of which antifungal agents comprised 23.8% of the total cost. Allogeneic haematopoietic stem cell transplant increased the excess cost (P = 0.013) and prolonged LOS (P < 0.001) whereas inpatient death within ≤28 days reduced both cost (P = 0.001) and LOS (P < 0.001). The median cumulative cost increased substantially to AUD203 292 over 1.5 years in cases with Scedosporium/L. prolificans infections. The economic burden associated with invasive Scedosporium/L. prolificans infections is substantial.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34238
DOI: 10.1093/jac/dkad345
ORCID: 0000-0002-5022-9060
0000-0002-5111-6367
0000-0002-8443-314X
Journal: The Journal of Antimicrobial Chemotherapy
PubMed URL: 37944018
ISSN: 1460-2091
Type: Journal Article
Appears in Collections:Journal articles

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