Record Details

Cost analysis of inappropriate treatments for suspected dermatomycoses

Farmeconomia

View Archive Info
 
 
Field Value
 
Title Cost analysis of inappropriate treatments for suspected dermatomycoses
 
Creator Fiammenghi, Emanuela
Patalano, Angela
Lo Conte, Viviana
Calabrò, Gabriella
 
Subject
Cost-analysis; Inappropriate treatments; Dermatomycoses; Mycological examination
 
Description Superficial mycoses are estimated to affect more than 20-25% of the world’s population with a consistent increase over the years. Most patients referred to our clinic for suspected dermatomycoses have already been treated with pharmacotherapy, without a previous mycological examination and many show changes in the clinical manifestations. Indeed, some medications, such as steroids, antiviral, antibiotics and antihistamines are not able to erase a fungal infection, but also they can cause atypical clinical manifestations. The consequences of inappropriate treatment include delayed diagnosis, prolonged healing time, and additional costs. The aims of this study were (1) to evaluate the incidence of increased costs attributable to inappropriate therapy sustained by the National Health Service and patients and (2) to highlight the importance of mycological evaluation before starting treatment, in order to improve diagnostic accuracy. An observational retrospective and prospective study was performed from September 2013 to February 2014, in 765 patients referred to our center (University Hospital “ Federico II”) in Naples, Italy, for suspected mycological infection. The following treatments (alone or in combination) were defined as inappropriate: (1) cortisone in a patient with at least one positive site; (2) antifungals in (a) patients with all negative sites or (b) ineffective antifungal treatment (in terms of drug chosen, dose or duration) in those with all positive sites; or (3) antibiotics; (4) antivirals or (5) antihistamines, in patients with ≥ 1 positive site. Five hundred and fifty patients were using medications before the assessment visit. The total amount of avoidable costs related to inappropriate previous treatments was € 121,417, representing 74% of the total treatment costs. 253/550 patients received drugs also after the visit. For these patients, the cost of treatment prescribed after mycological testing was € 42,952, with a decrease with respect to the total consumption of drugs at the time of access to the Mycology Laboratory of € 34,781. Thus, our cost analysis shows that it is important to obtain a reduction of costs for pathologies that need to be confirmed by examinations before starting treatment.
 
Publisher SEEd
 
Contributor
 
Date 2015-06-30
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion

 
Format text/html
application/pdf
 
Identifier http://journals.edizioniseed.it/index.php/FE/article/view/1172
10.7175/fe.v16i2.1172
 
Source Farmeconomia. Health economics and therapeutic pathways; Vol 16, No 2 (2015); 39-44
2240-256X
1721-6915
 
Language eng
 
Relation http://journals.edizioniseed.it/index.php/FE/article/view/1172/1432
http://journals.edizioniseed.it/index.php/FE/article/view/1172/1433
 
Coverage


 
Rights Copyright (c) 2015 Farmeconomia. Health economics and therapeutic pathways