Thinking critically about the value and cost of drugs: managing patients with invasive fungal disease
There is a temptation to switch to cheaper generic antiretroviral drugs compared to fixed-dose combination therapy for HIV patients in the interests of cost savings. However, in our analysis we found that there were no costs saved when including all patient care including drugs, additional clinic visits and monitoring. We also found that switching may cause confusion for some patients, risking loss of adherence. This evidence can help commissioners make better policy decisions about drug provision.
We first created a generic framework to help decision-makers think about how to compare patient management whilst considering all costs to the healthcare provider. Then, we developed a specific tool for management of patients with invasive fungal disease (IFD). Lastly, we estimated that the attributable cost of managing adult haematology patients with IFD at Kings College Hospital (London) was more than £50,000 per case, with the inpatient stay cost far outstripping the cost of antifungal drugs.