Clostridioides Difficile Is Expensive

The infection known as ‘C diff’ is caused by the organism Clostridioides* difficile. It’s often the result of antibiotic therapy, since antibiotic use can disrupt the normal microbial flora, making way for C. difficile. This means this infections are likely to occur in people who are already sick, including the immunocompromised. It doesn’t help that C. difficile is a spore-forming organism, meaning it’s very hard to get rid of in a hospital or any other setting. That also is one way patients can get recurrent C. difficile infections (for brevity, C. difficile infections will be called CDI). In 2011, there were 435,000 primary CDIs, and 83,000 recurrent CDIs (primary CDIs are first time infections).

A recent study suggests that the economic cost of CDIs is quite high. Overall, the average additional cost of a CDI was estimated to be over $24,500. Interesting, these infections were more costly in men than women ($19,700 versus $31,000); no idea why that would be. But the largest effect is seen in the difference between non-immunocompromised and immunocompromised patients, where CDI in the immunocompromised costs an additional $37,000 (this seems to be due to a longer course of infection).

Recurrent CDIs are even more expensive adding an additional $10,000 in expenses (and $16,500 if the patient is immunocompromised). The 2018 costs are probably well north of $13 billion per year (remember these are 2011 data), as CDIs seem to be more of a problem now than in 2011 (also, healthcare cost inflation). Is this the largest cost in the U.S. healthcare system? Obviously not. But to put this in perspective, the costs of CDIs in the U.S. are about the same as the cost of the entire CHIP program.

That’s probably something worth getting excited about. It’s also another reason why we need to focus not only on healthcare insurance payments, but actual healthcare.

*Clostriodoides difficile used to be called Clostridium difficile, until some microbial taxonomists decided that was a bad name and changed it to Paraclostridioides difficile. This pissed off regular humans, who were used to calling it “C. difficile” and “C diff” (importantly, this kind of name change can ‘break the literature’), so it was changed again to Clostriodides difficile.

This entry was posted in Economics, Microbiology, Public Health. Bookmark the permalink.

One Response to Clostridioides Difficile Is Expensive

  1. Monardella says:

    From directorsblog.nih.gov: “What Britton and colleagues noticed is the more widespread use of manufactured trehalose coincided with early reports of C. diff. outbreaks.” Trehalose was approved in 2000 and is used in ice cream.
    https://directorsblog.nih.gov/2018/01/09/has-a-sucrose-alternative-contributed-to-the-c-diff-epidemic/

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