Economic impact of antifungal treatment in IFD by <i>Candida</i> species: anidulafungin administration as a cost-effective alternative for critical care patients
Bibliographic record
Abstract
Objectives To evaluate the potential savings resulting from the substitution of caspofungin and liposomal amphotericin B with anidulafungin in intensive care units (ICUs), where appropriate, for the treatment of invasive fungal disease. Methods We conducted a retrospective analysis on patients admitted to two ICUs at S. Giovanni Battista hospital in Turin (IT). Included patients were admitted during the year 2010 for ≥3 days. We evaluated the substitutability index of caspofungin and liposomal amphotericin B with anidulafungin. According to the index, we created an economical model in order to project the potential savings for the entire hospital. Results A total of 179 medical records were included in the analysis. We evaluated 488 doses of antifungals administered, including: 174 anidulafungin, 209 caspofungin and 105 liposomal amphotericin B. Anidulafungin was found to be a possible substitute for a total of 166 doses of caspofungin and 43 doses of liposomal amphotericin B. The substitutability index was 79.4% and 40.9%, respectively, for caspofungin and liposomal amphotericin B. The projected savings would be €37 300 for all of the departments examined. If this antifungal drug had not been included in the hospital formulary, and thus not administered in the two ICUs, the hospital would have spent €42 747 more. According to our model the differential cost is equal to 37 300+42 747=€80 047. Conclusions The savings we obtained is proportional to our substitutability index based on a sample of patients admitted to our ICUs. We assume that highly specialised hospitals may obtain an index higher than the one we obtained. Therefore, greater savings proportional to the number of patients treated are expected.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".