Rezafungin as a Strategy to Reduce ICU-Related Costs in Patients with Invasive Candidiasis and Candidemia: A Perspective from the Brazilian Supplementary Health System

Abstract

Objective: To evaluate the number of intensive care unit (ICU) hospitalization days associated with the use of rezafungin versus standard echinocandin therapy in adult patients with candidemia or invasive candidiasis, from the perspective of the Brazilian supplementary health system.

Methods: This exploratory analysis used pooled data from two randomized clinical trials including adult patients treated with weekly rezafungin or standard echinocandins (caspofungin, micafungin, and anidulafungin), all administered daily. Only patients requiring ICU hospitalization were included. Outcomes included length of ICU stay and the total number of intravenous infusions over a 28-day treatment horizon. The daily ICU cost was estimated through a micro-costing approach based on official Brazilian data sources.

Results: Patients treated with rezafungin had a shorter mean ICU length of stay compared with those receiving standard echinocandins (17.3 vs. 21.4 days), representing a reduction of 4.1 days. With an estimated ICU cost of R$2,894.69 per day, this difference corresponds to a potential saving of R$11,868.25 per patient from the perspective of the supplementary health system.

Conclusions: In patients with invasive candidiasis, rezafungin has the potential to significantly reduce ICU resource utilization within the Brazilian supplementary health system, resulting in substantial cost savings.