ORGANIZATIONAL AND ECONOMIC IMPACT OF INTRODUCING REZAFUNGIN FOR INVASIVE CANDIDIASIS IN NON-NEUTROPENIC ADULTS: COMPARISON WITH CASPOFUNGIN
Author(s)
Marine Robin, PharmD student1, VIRGINIE SIORAT, PharmD2, OLIVIER PARENT DE CURZON, PharmD2, PASCAL PAUBEL, PharmD2, Marion TANO, PharmD2, ALBANE DEGRASSAT THEAS, PharmD2.
1Faculty of pharmacy, Paris Cité University, Paris, France, 2AGEPS - APHP, Paris, France.
1Faculty of pharmacy, Paris Cité University, Paris, France, 2AGEPS - APHP, Paris, France.
OBJECTIVES: Invasive candidiasis is a serious fungal infection associated with prolonged hospital stays and increased healthcare costs. Daily echinocandins such as caspofungin are recommended as first-line therapy. Rezafungin, added to the hospital formulary in France in 2025 and administered once weekly, has a substantially higher acquisition cost but may enable earlier discharge with outpatient continuation.This study estimates the organizational and economic impact of introducing rezafungin for selected indications, from both the French National Health Insurance (payer) and our hospital perspectives.
METHODS: Inputs were informed by published evidence and collected healthcare data from 2025.Two scenarios were evaluated independently against a reference strategy of continuous inpatient caspofungin for 42 days: (1) rezafungin with early discharge and continuation with weekly day-hospital sessions; (2) inpatient caspofungin followed by rezafungin switching at discharge. The analysis focused on DRG (Diagnosis-Related Group) categories for acute/subacute endocarditis (severity levels 2-4), as an example of long-stay admissions. Discharge occurred at observed mean LOS (length of stay) with post-discharge weekly sessions.
RESULTS: From the hospital perspective, in scenario 1, rezafungin generated a favourable differential hospital impact versus inpatient caspofungin, driven by earlier discharge: avoided bed-day costs outweighed higher acquisition costs and outpatient sessions across tested LOS. In scenario 2, switching from inpatient caspofungin to rezafungin at discharge generated a higher favourable differential hospital impact than scenario 1, reflecting reduced inpatient rezafungin exposure and avoided prolonged inpatient costs overall.From the payer perspective, within typical stays (10-25 days), shortening LOS does not reduce inpatient reimbursement. As antifungal costs are included in DRG-associated tariffs, payer impact is mainly driven by post-discharge outpatient sessions.
CONCLUSIONS: Overall, rezafungin may optimise care pathways: although total treatment costs remained higher than corresponding DRG and outpatient reimbursement tariffs, rezafungin reduced the hospital deficit compared with inpatient caspofungin, while payer impact was mainly driven by outpatient administration.
METHODS: Inputs were informed by published evidence and collected healthcare data from 2025.Two scenarios were evaluated independently against a reference strategy of continuous inpatient caspofungin for 42 days: (1) rezafungin with early discharge and continuation with weekly day-hospital sessions; (2) inpatient caspofungin followed by rezafungin switching at discharge. The analysis focused on DRG (Diagnosis-Related Group) categories for acute/subacute endocarditis (severity levels 2-4), as an example of long-stay admissions. Discharge occurred at observed mean LOS (length of stay) with post-discharge weekly sessions.
RESULTS: From the hospital perspective, in scenario 1, rezafungin generated a favourable differential hospital impact versus inpatient caspofungin, driven by earlier discharge: avoided bed-day costs outweighed higher acquisition costs and outpatient sessions across tested LOS. In scenario 2, switching from inpatient caspofungin to rezafungin at discharge generated a higher favourable differential hospital impact than scenario 1, reflecting reduced inpatient rezafungin exposure and avoided prolonged inpatient costs overall.From the payer perspective, within typical stays (10-25 days), shortening LOS does not reduce inpatient reimbursement. As antifungal costs are included in DRG-associated tariffs, payer impact is mainly driven by post-discharge outpatient sessions.
CONCLUSIONS: Overall, rezafungin may optimise care pathways: although total treatment costs remained higher than corresponding DRG and outpatient reimbursement tariffs, rezafungin reduced the hospital deficit compared with inpatient caspofungin, while payer impact was mainly driven by outpatient administration.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE492
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Organizational Practices
Topic Subcategory
Budget Impact Analysis
Disease
Infectious Disease (non-vaccine)