Fever of unknown origin: cost of illness study

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Abstract
Objectives: To analyze the structure of direct treatment costs for FUO and identify key cost-driving factors. Methods: A retrospective pharmacoeconomic analysis using a bottom-up approach was conducted on 71 patients treated for FUO at the Clinic for Infectious Diseases, University Clinical Centre Kragujevac, between 2016 and 2022. Treatment cost data were extracted from the electronic medical records. Results: The total direct cost was €81,655.20, with a mean of €1,150.07 ± 3,434.60 per patient with a median of €549.55 (IQR=€512.62). Major cost components included pharmacotherapy (49.40 %; €40,337.26), diagnostic procedures (30.52 %; €24,923.44), and hospitalisation (10.32 %; €8,324.00). Significant cost determinants were the following: gender, the Charlson comorbidity index, hospital stay duration, number of medications administered per patient, and number of specialist consultations. Conclusions: Pharmacotherapy, especially broad-spectrum antibiotics and antifungals, along with diagnostics and hospitalisation, are the main contributors to FUO treatment costs. Patient-specific factors, particularly comorbidities and service utilisation, play a significant role in determining overall healthcare expenditure.

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