Influence of drug class and healthcare setting on systemic antifungal expenditures in the United States, 2005-15

Margaret A. Fitzpatrick*, Katie J. Suda, Charlesnika T. Evans, Robert J. Hunkler, Frances Weaver, Glen T. Schumock

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


Purpose: Overall and specific class trends in systemic antifungal expenditures in various U.S. healthcare settings from 2005 through 2015 were evaluated. Methods. Systemic antifungal expenditures from January 1, 2005, through December 31, 2015, were obtained from the QuintilesIMS National Sales Perspective database, which provides a statistically valid projection of medication purchases from multiple markets throughout the United States. Summary data for total antifungal expenditures over the entire period are reported, as are growth and the percentage change in expenditures from one year to the next. Expenditures were also assessed specifically by year, class, and healthcare setting. Expenditure trends over the study period were assessed using simple linear trend regression models. Results. Overall expenditures for the 11-year period were $9.37 billion. The greatest proportion of expenditures occurred in nonfederal hospitals (47.2%) and for triazoles (57.6%). From 2005 through 2015, total expenditures decreased from $1.1 billion to $894 million (-18.8%, p = 0.09); however, expenditures in clinics and retail pharmacies increased (202%, p < 0.01, and 13.8%, p = 0.04, respectively), a trend most pronounced after 2012. Expenditures for flucytosine also increased (968.1%, p < 0.01), particularly in clinics where there was a dramatic 6,640.9% increase (p < 0.01). Conclusion: From 2005 through 2015, an increase in systemic antifungal expenditures was observed in community settings, despite an overall decrease in total antifungal expenditures in the United States. Large increases in flucytosine expenditures were observed, particularly in the community.

Original languageEnglish (US)
Pages (from-to)1076-1083
Number of pages8
JournalAmerican Journal of Health-System Pharmacy
Issue number14
StatePublished - Jul 15 2017


  • Antifungal agents
  • Health expenditures
  • Prescription drugs

ASJC Scopus subject areas

  • Pharmacology
  • Health Policy


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