459. The Economic Burden Associated with Zygomycosis-Related Hospitalizations in the US
Session: Poster Abstract Session: Mucor, Fusarium, and other Filamentous Mycoses
Thursday, October 8, 2015
Room: Poster Hall
Background: Zygomycosis, most commonly caused by mucorales, is a rare opportunistic fungal infection primarily affecting immunocompromised patients. Although the infection is uncommon, due to rapid disease progression, high mortality rate and cost, the identification and treatment of this condition needs to be effective. A study from 2009 found that an episode of zygomycosis infection resulted in an average direct cost of $97,743, with an overall cost of $50 million per year. The objective of this study was to assess the economic burden of zygomycosis-related hospitalizations including hospital length of stay (LOS), readmission rate, and cost.

Methods: The Premier Perspective Comparative Database (PPCD), a hospital-based database with detailed inpatient and outpatient encounters and cost data, was used to assess the economic impact of zygomycosis (2005-2014).  The following criteria had to be met: 1) presence of ICD-9 code 117.7 and/or microbiology diagnosis and 2) evidence of amphotericin B or posaconazole utilization. All costs were inflated to 2014 USD using the Consumer Price Index medical care component.

Results: A total of 555 cases were identified between 2005 and 2014. The mean age was 51.7 years and 63% were male. The most common underlying conditions were diabetes (46%), pneumonia (49%), and hematological malignancies (40%). The mean (SD) LOS was 26 (29) days and all-cause readmission rates for one and three-months were 30% and 37%, respectively. The average cost (SD) per hospital stay (2014 USD) was $112,419 ($159,144) with a range from $1,912 to $1,395,163. The mean (SD) daily cost was $4,096 ($2,683) with a range from $768 to $19,728. 

Conclusion: Despite the wide variation in total zygomycosis-related hospitalization costs, findings suggest that the initial hospitalization cost is on the rise. The economic burden is worse considering that costs associated with rehospitalization were not included in the cost analysis. Despite its low prevalence compared to more chronic conditions such as diabetes, the fact that this infection mostly occurs in a very high-risk population and is associated with high costs, zygomycosis should be a priority among those managing similar patient populations.

Hongbo Yang, PhD1, Chelsey Yang, BA1, Sneha Kelkar, MPH1, Jinlin Song, PhD1, Alan Fan, PhD2, Nkechi Azie, MD2, Edward Lee, PharmD2 and James Spalding, PharmD, MS, MBA2, (1)Analysis Group, Boston, MA, (2)Astellas Pharma Global Development, Inc., Northbrook, IL

Disclosures:

H. Yang, None

C. Yang, None

S. Kelkar, None

J. Song, None

A. Fan, None

N. Azie, Astellas: Employee , Salary

E. Lee, Astellas: Employee , Salary

J. Spalding, Astellas: Employee , Salary

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