Background: The aim of this study was to assess the cost of antifungal drugs used in the treatment of febrile neutropenic episodes of patients with hematological malignancies.
Materials/methods:The cost of antifungal drugs used in the treatment of adult patients who were followed at the department of Hematology of Ministry of Health Okmeydanı Research Hospital between November 2010 and November 2012 due to hematological malignancies and had febrile neutropenia attacks (FNA) were assessed, retrospectively.
Results: The cost of antifungal drugs was calculated and evaluated in 126 patients, who had 282 FNA were evaluated. The mean age of patients, who 60 patients were female, was 51.73 ± 14.4 years (range: 17–82 years). The mean MASCC score was 17.18 ± 8.27. The mean duration of FNA was 29.38 ± 6.95 days. During 282 febrile episodes of 126 patients, systemic antifungal drugs were administered to 23 patients with 31 culture-proven invasive fungal infection (IFI), 19 patients with probable invasive pulmonary aspergillosis (IPA) in 25 febrile neutropenia episodes, 38 patients with possible IPA in 42 febrile neutropenia episodes, and 30 patients with suspected IFI in 31 febrile neutropenia episodes, respectively.
Liposomal amphotericin B (L-AmB) was calculated to cost $29322.98 per month, $366537.43 per year with 0.21 patient daily dose/100 patient days as the most costly antifungal drug. Total cost were calculated to be $1,271,789.08/year and $18039/ patient for antifungal drugs. The costs of antifungal drugs were found to be $3857.85 for voriconazole (VOR), $15783.34 for caspofungin, $21561.02 for L-AmB per febrile neutropenic episode, respectively. The cost of posaconazole was $32167.39/patient for the prophylaxis use.
Conclusions: Antifungal drugs pose a serious cost in the treatment of IFI. The costs could be reduced with those measures, including an accurate and fully implemented infection control measures, an administration of preemptive antifungal treatment instead of empirical antifungal treatment, switching from intravenous form of VOR to tablet form when it is possible, an administration of VOR for the secondary prophylaxis of invasive aspergillosis, and use of L-AmB as a secondary choice or in the salvage therapy.
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Full conference title:
- ECCMID 30th (2020)