EX-ANTE HEALTH ECONOMIC EVALUATION OF PERSONALIZED CARE PATHWAYS FOR ICU PATIENTS WITH INFLUENZA-ASSOCIATED PULMONARY ASPERGILLOSIS USING DISCRETE-EVENT SIMULATION
Author(s)
Angelina T. Villikudathil, PhD1, Daniel Felber, MD2, Sarah Sedik, Msc2, Martin Hoenigl, MD FECMM2, Joost Wauters, MD3, Frank van de Veerdonk, MD4, Vincent Augusto, PhD5, Marius Huguet, PhD1.
1Centre for Biomedical and Healthcare Engineering, Mines Saint-Etienne, Saint Etienne, France, 2Department of Internal Medicine, Medical University of Graz, Graz, Austria, 3Medical Intensive Care Unit, Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium, 4Department of Internal Medicine and Radboudumc Community for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, Netherlands, 5Univ Clermont Auvergne, INP Clermont Auvergne, CNRS, UMR 6158 LIMOS, Mines Saint-Etienne, Saint Etienne, France.
1Centre for Biomedical and Healthcare Engineering, Mines Saint-Etienne, Saint Etienne, France, 2Department of Internal Medicine, Medical University of Graz, Graz, Austria, 3Medical Intensive Care Unit, Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium, 4Department of Internal Medicine and Radboudumc Community for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, Netherlands, 5Univ Clermont Auvergne, INP Clermont Auvergne, CNRS, UMR 6158 LIMOS, Mines Saint-Etienne, Saint Etienne, France.
OBJECTIVES: Influenza associated invasive pulmonary aspergillosis (IAPA) is a frequent complication of severe influenza in the intensive care unit (ICU) and a significant expense of Euros 14 billion annually is spent in the European Union for managing influenza. IAPA is a major driver of mortality in patients requiring ICU treatment for severe influenza, with mortality rates as high as 45% in those with IAPA. This research addresses three objectives: to develop a discrete event simulation (DES) performance evaluation framework comparing the direct costs between a) standard of care (SOC) of IAPA management for critically ill patients in the ICU; b) using a precision medicine approach of single nucleotide polymorphism (SNP) based early targeted antifungal prophylaxis or c) in universal antifungal prophylaxis. We evaluate various ways of integrating the LGALS3 SNP as companion biomarker into the care pathway before implementation in clinical settings, to inform a future clinical trial.
METHODS: We utilized data from treated patients in Belgium, the Netherlands and Austria, to calibrate and validate the DES model of the SOC pathway. We incorporated a health economic evaluation of health service delivery towards IAPA management utilising a precision medicine approach. We used Python and R kernals in Jupyter Notebook for downstream analysis and AnyLogic software for DES modelling.
RESULTS: We considered two scenarios: a) early targeted therapy by predicting IAPA susceptibility using SNPs as companion biomarker and b) universal prophylaxis wherein no screening is involved and the treatment is performed for all admissions. Combining health economics and care pathway simulations, we obtained the indicator of survival outcomes and direct costs of ICU care.
CONCLUSIONS: This research contributes a state-of-the-art prior evaluation of care process from health technology value frameworks in the management of IAPA. This informs the economic implications towards health policy which could benefit national regulatory expenditures.
METHODS: We utilized data from treated patients in Belgium, the Netherlands and Austria, to calibrate and validate the DES model of the SOC pathway. We incorporated a health economic evaluation of health service delivery towards IAPA management utilising a precision medicine approach. We used Python and R kernals in Jupyter Notebook for downstream analysis and AnyLogic software for DES modelling.
RESULTS: We considered two scenarios: a) early targeted therapy by predicting IAPA susceptibility using SNPs as companion biomarker and b) universal prophylaxis wherein no screening is involved and the treatment is performed for all admissions. Combining health economics and care pathway simulations, we obtained the indicator of survival outcomes and direct costs of ICU care.
CONCLUSIONS: This research contributes a state-of-the-art prior evaluation of care process from health technology value frameworks in the management of IAPA. This informs the economic implications towards health policy which could benefit national regulatory expenditures.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA249
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Health Technology Assessment
Disease
Infectious Disease (non-vaccine), Personalized & Precision Medicine