Session: Poster Session: Fungal Epidemiology
Saturday, October 25, 2008: 12:00 AM
Room: Hall C
Background: No studies determining the contemporaneous cost and resource utilisation of an IFI have been performed in Australasia using modern costing techniques (i.e. micro-costing). Methods: Patients post Allo SCT or undergoing chemotherapy for acute leukaemia who were admitted to The Alfred Hospital between 1 Jan 2004 and 31 Dec 2006 and who developed an IFI were identified using ICD10 codes and were compared to matched controls without IFI. Controls were matched for Allo SCT or acute leukaemia and length of stay (LOS).Total cost was determined using micro-costing data (e.g. pathology, radiology, surgery and ward staff costs), pharmacy dispensing and drug acquisition cost data available for financial years 2004-2006. Results: 17 patients with IFI (male 75%, mean age 47y; 14 candidiasis and 5 aspergillosis) and 171 control patients (male 45%, mean age 53y) were identified. Average LOS for cases and controls was 42d and 18d respectively. The mean cost of an admission with an IFI was AU$215,248 and AU$29,193 for controls reflecting an incremental cost of AU$186,055 with pharmacy, ward and ICU costs accounting for 47%, 18% and 9% of the difference respectively. The most frequently used antifungal agent was liposomal amphotericin (38%) When all subsequent admissions over the next 3 months (including those<3d) were included, the mean cost was AU$302,563 per IFI and AU$64,911 per control with pharmacy costs dominant comprising 52% of the difference. Conclusions: The current cost of IFIs in high risk haematology patients is significant at AU$186,055 per admission and AU$237,652 per patient with pharmacy costs being major cost driver. Verification of these data by chart review is in progress.