BACKGROUND

Candidaemia and invasive candidiasis (IC) remain significant causes of morbidity and mortality. The associated health economic burden is largely due to prolonged hospital and intensive care unit (ICU) stays. Rezafungin is a next-generation once-weekly echinocandin demonstrating a prolonged half-life and high front-loaded plasma exposures.

OBJECTIVES

To examine ICU length of stay (LOS) data and associated impact on projected healthcare costs, based on UK NHS ICU costs, using post-hoc analysis of early treatment outcomes from the rezafungin STRIVE clinical trial (NCT02734862).

METHODS

STRIVE comprised a global, Phase 2, prospective, multicentre, double-blind, comparator study. Adults with candidemia and/or IC (n=183) were randomised to receive the rezafungin 400/400mg (n=76) or 400/200mg (n=46) dose, or caspofungin standard dose (n=61) for ≤4 weeks. Overall cure rate at Day 5 was evaluated and ICU LOS was reported for the full study period. Post-hoc analysis calculated projected ICU stay costs for the rezafungin 400/200 mg and caspofungin groups based on a pooled average unit cost derived from National Schedule of NHS Costs (2018/2019; £1,504/day).

RESULTS

Respective Day 5 overall cure rates with rezafungin 400/400mg, rezafungin 400/200mg and caspofungin were 55.3% (42/76), 73.9% (34/46) and 55.7% (34/61). Of the 183 patients included, 91 were in the ICU. Median LOS ahead of ICU discharge was 13 (range 2–48) days with rezafungin 400/200mg and 18 (range 1–61) days with caspofungin treatment. The resulting 5-day reduction in ICU LOS with rezafungin 400/200mg treatment was associated with a potential decrease in healthcare expenditure of £7,520 per discharged patient.

CONCLUSIONS

For the treatment of candidemia and IC, early treatment efficacy with rezafungin was demonstrated by numerical improvements in overall cure at Day 5 and a shorter ICU LOS. In the UK, these outcomes may translate to potential spending reductions concerning LOS in the ICU of approximately £7,520 per discharged patient.