Title |
Economic analysis of empiric versus diagnostic-driven strategies for immunocompromised patients with suspected fungal infections in the People's Republic of China
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Published in |
ClinicoEconomics and Outcomes Research: CEOR, June 2016
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DOI | 10.2147/ceor.s101015 |
Pubmed ID | |
Authors |
Ningying Mao, Beth Lesher, Qifa Liu, Lei Qin, Yixi Chen, Xin Gao, Stephanie R Earnshaw, Cheryl L McDade, Claudie Charbonneau |
Abstract |
Invasive fungal infections (IFIs) require rapid diagnosis and treatment. A decision-analytic model was used to estimate total costs and survival associated with a diagnostic-driven (DD) or an empiric treatment approach in neutropenic patients with hematological malignancies receiving chemotherapy or autologous/allogeneic stem cell transplants in Shanghai, Beijing, Chengdu, and Guangzhou, the People's Republic of China. Treatment initiation for the empiric approach occurred after clinical suspicion of an IFI; treatment initiation for the DD approach occurred after clinical suspicion and a positive IFI diagnostic test result. Model inputs were obtained from the literature; treatment patterns and resource use were based on clinical opinion. Total costs were lower for the DD versus the empiric approach in Shanghai (¥3,232 vs ¥4,331), Beijing (¥3,894 vs ¥4,864), Chengdu, (¥4,632 vs ¥5,795), and Guangzhou (¥8,489 vs ¥9,795). Antifungal administration was lower using the DD (5.7%) than empiric (9.8%) approach, with similar survival rates. Results from one-way and probabilistic sensitivity analyses were most sensitive to changes in diagnostic test sensitivity and IFI incidence; the DD approach dominated the empiric approach in 88% of scenarios. These results suggest that a DD compared to an empiric treatment approach in the People's Republic of China may be cost saving, with similar overall survival in immunocompromised patients with suspected IFIs. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 14 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 4 | 29% |
Student > Master | 4 | 29% |
Other | 2 | 14% |
Student > Postgraduate | 1 | 7% |
Unknown | 3 | 21% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 5 | 36% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 14% |
Business, Management and Accounting | 1 | 7% |
Biochemistry, Genetics and Molecular Biology | 1 | 7% |
Immunology and Microbiology | 1 | 7% |
Other | 1 | 7% |
Unknown | 3 | 21% |