Please use this identifier to cite or link to this item:
Title: Cost-effectiveness Comparison of Ceftazidime/Avibactam Versus Meropenem in the Empirical Treatment of Hospital-acquired Pneumonia, Including Ventilator-associated Pneumonia, in Italy
Author: Tichy, Eszter
Torres Martí, Antoni
Bassetti, Matteo
Kongnakorn, Thitima
Virgilio, Roberto Di
Irani, Paurus
Charbonneau, Claudie
Keywords: Anàlisi cost-benefici
Infeccions nosocomials
Respiració artificial
Cost effectiveness
Nosocomial infections
Artificial respiration
Issue Date: Apr-2020
Publisher: Elsevier B.V.
Abstract: Purpose: Ceftazidime/avibactam (CAZ-AVI) is a fixed-dose combination antibiotic approved in Europe and the United States for patients with hospitalacquired pneumonia, including ventilator-associated pneumonia (HAP/VAP). The economic benefits of a new drug such as CAZ-AVI are required to be assessed against those of available comparators, from the perspective of health care providers and payers, through cost-effectiveness and cost-utility analyses. The objective of this analysis was to compare the cost-effectiveness of CAZ-AVI versus meropenem in the empirical treatment of appropriate hospitalized patients with HAP/VAP caused by gram-negative pathogens, from the perspective of publicly funded health care in Italy (third-party perspective, based on the data from the REPROVE (Ceftazidime-Avibactam Versus Meropenem In Nosocomial Pneumonia, Including Ventilator-Associated Pneumonia) clinical study; NCT01808092). Methods: A patient-level, sequential simulation model of the HAP/VAP clinical course was developed using spreadsheet software. The analysis focused on direct medical costs. The time horizon of the model selected was 5 years, with an annual discount rate of 3% on costs and quality-adjusted life-years (QALYs). Clinical inputs for treatment comparisons were mainly obtained from the REPROVE clinical study data. In addition to clinical outcomes observed in the trial, the model incorporated impact of resistance pathogens, based on data from published studies and expert opinion. Certain assumptions were made for some model parameters due to a lack of data. Findings: The analysis demonstrated that the intervention sequence (CAZ-AVI followed by colistin + high-dose meropenem) versus the comparator sequence (meropenem followed by colistin + high-dose meropenem) provided a better clinical cure rate (+13.52%), which led to a shorter hospital stay (−0.40 days per patient), and gains in the number of life-years (+0.195) and QALYs (+0.350) per patient. The intervention sequence had an estimated net incremental total cost of V1254 ($1401) per patient, and the estimated incremental cost-effectiveness ratio was V3581 ($4000) per QALY gained, well below the willingness-topay threshold of V30,000 ($33,507) per QALY in Italy. Implications: The model results showed that CAZAVI is expected to provide clinical benefits in hospitalized patients with HAP/VAP in Italy at an acceptable cost compared to meropenem.
Note: Reproducció del document publicat a:
It is part of: Clinical Therapeutics, 2020, vol. 42, num. 5
Related resource:
ISSN: 0149-2918
Appears in Collections:Articles publicats en revistes (Medicina)

Files in This Item:
File Description SizeFormat 
701132.pdf1.48 MBAdobe PDFView/Open

This item is licensed under a Creative Commons License Creative Commons