BUDGETIMPACT AND COST CONSEQUENCES OF REZAFUNGIN ADOPTION VERSUS DAILY ECHINOCANDINS FOR INVASIVE CANDIDIASIS IN SAUDI ARABIA
Author(s)
Ibtisam H. Alharbi, PharmD, MSc1, Abdallah Almohizea, Pharm. D, FIDP, PPCR.2, Hajer Al Qahtani, BSc, PharmD, MSc3, Laila Alanizy, PharmD,4, Imtinan Abdullah Almasoudi, PharmD, MPH, BCPS, SSC-PhP, SSC-IDP5, Sara Almuhisen, PharmD4, Abdullah Alshahrani, BSc Pharm, MSc, FHEOR, FHA, Dip SCM6, Ibrahim Abdulaziz Alsaagi, MS, PharmD, PhD5, Wael Bajhmom, PhD, MSc,MTID7, Ali Al Saeed, MD8, Abdulrahman Nugali, PharmD9.
1Ministry of Defense Health Services, Jeddah, Saudi Arabia, 2King Faisal Specialist Hospital, Riyadh, Saudi Arabia, 3Department of Pharmaceutical Care, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia, 4King Fahad Medical City, Riyadh, Saudi Arabia, 5King Saud Medical City, Riyadh, Saudi Arabia, 6Pharmaceutical Care Department, Armed forces hospitals southern region, Khamis Mushait, Saudi Arabia, 7King Fahad Hospital, Jeddah, Saudi Arabia, 8Dammam Medical Complex, Dammam, Saudi Arabia, 9HEPA Solutions, Jeddah, Saudi Arabia.
1Ministry of Defense Health Services, Jeddah, Saudi Arabia, 2King Faisal Specialist Hospital, Riyadh, Saudi Arabia, 3Department of Pharmaceutical Care, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia, 4King Fahad Medical City, Riyadh, Saudi Arabia, 5King Saud Medical City, Riyadh, Saudi Arabia, 6Pharmaceutical Care Department, Armed forces hospitals southern region, Khamis Mushait, Saudi Arabia, 7King Fahad Hospital, Jeddah, Saudi Arabia, 8Dammam Medical Complex, Dammam, Saudi Arabia, 9HEPA Solutions, Jeddah, Saudi Arabia.
OBJECTIVES: Invasive candidiasis (IC) is associated with high ICU mortality and substantial resource use. Rezafungin, dosed once weekly, may shift administration and inpatient costs relative to daily echinocandins through earlier discharge and outpatient transition rather than differential efficacy. This analysis estimated the budget impact and cost consequences of adopting rezafungin for eligible adult IC patients in Saudi public hospitals.
METHODS: A cost-calculator budget impact model was developed from the public payer perspective over a 1 to 5 year horizon, comparing rezafungin with caspofungin (principal national-tender comparator; anidulafungin and micafungin as alternates) in ICU, outpatient parenteral antimicrobial therapy (OPAT) home, and OPAT center. Drug acquisition costs were sourced from the National Tender Drug List (2025). Healthcare resource utilization costs were obtained from public hospital business centers and validated by local experts. Eligible patient populations were estimated using GSTAT (General Authority for Statistics) national statistics and published Saudi IC incidence data. Length-of-stay (LOS) differentials were informed by literature review publications.
RESULTS: An estimated 2,499 adult IC patients are eligible for ICU echinocandin therapy annually in Saudi Arabia. In the ICU setting, rezafungin was associated with a total per-patient cost of $22,510 versus $24,543 for caspofungin, reflecting a 4.1-day LOS reduction (17.3 vs. 21.4 days). Despite higher drug acquisition costs ($6,379 vs. $1,368), projected net savings were $1.0M in Year 1 and $7.6M over 5 years. Among OPAT-eligible patients, rezafungin reduced per-patient costs by $2,440 (home) and $424 (center) versus caspofungin.
CONCLUSIONS: Reflecting an estimated LOS reduction of 4.1 days based on published evidence, the once-weekly dosing of rezafungin reduces resource utilization in a manner that outweighs its higher acquisition cost, resulting in projected budget savings for Saudi public payers across ICU and OPAT settings. Formulary adoption of rezafungin represents cost-saving strategy for managing IC in KSA.
METHODS: A cost-calculator budget impact model was developed from the public payer perspective over a 1 to 5 year horizon, comparing rezafungin with caspofungin (principal national-tender comparator; anidulafungin and micafungin as alternates) in ICU, outpatient parenteral antimicrobial therapy (OPAT) home, and OPAT center. Drug acquisition costs were sourced from the National Tender Drug List (2025). Healthcare resource utilization costs were obtained from public hospital business centers and validated by local experts. Eligible patient populations were estimated using GSTAT (General Authority for Statistics) national statistics and published Saudi IC incidence data. Length-of-stay (LOS) differentials were informed by literature review publications.
RESULTS: An estimated 2,499 adult IC patients are eligible for ICU echinocandin therapy annually in Saudi Arabia. In the ICU setting, rezafungin was associated with a total per-patient cost of $22,510 versus $24,543 for caspofungin, reflecting a 4.1-day LOS reduction (17.3 vs. 21.4 days). Despite higher drug acquisition costs ($6,379 vs. $1,368), projected net savings were $1.0M in Year 1 and $7.6M over 5 years. Among OPAT-eligible patients, rezafungin reduced per-patient costs by $2,440 (home) and $424 (center) versus caspofungin.
CONCLUSIONS: Reflecting an estimated LOS reduction of 4.1 days based on published evidence, the once-weekly dosing of rezafungin reduces resource utilization in a manner that outweighs its higher acquisition cost, resulting in projected budget savings for Saudi public payers across ICU and OPAT settings. Formulary adoption of rezafungin represents cost-saving strategy for managing IC in KSA.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE490
Topic
Economic Evaluation, Health Technology Assessment, Real World Data & Information Systems
Topic Subcategory
Budget Impact Analysis, Cost/Cost of Illness/Resource Use Studies
Disease
Infectious Disease (non-vaccine), No Additional Disease & Conditions/Specialized Treatment Areas