Journal article

Publication year: 2019

Pages: 633-641

Journal: International Journal of Antimicrobial Agents

Volume number: 54

Issue number: 5

ISSN: 0924-8579

eISSN: 1872-7913

Open access status: Hybrid

DOI Link: https://doi.org/10.1016/j.ijantimicag.2019.06.008

Publisher: Elsevier

Abstract: 
Ceftazidime/avibactam (CAZ-AVI) is a novel, fixed-dose combination antibiotic that has been approved in Europe and the United States for patients with complicated urinary tract infections (cUTIs) based on results of a Phase III, randomized, comparative study (RECAPTURE study). The present analysis evaluated cost-effectiveness of CAZ-AVI as an empirical treatment for hospitalized patients with cUTIs from the Italian publicly funded healthcare (third-party payer) perspective. A sequential, patient-level simulation model was developed that followed the clinical course of cUTI and generated 50 00 pairs of identical patients (CAZ-AVI or imipenem as empirical treatment). The model included additional impact of resistant pathogens; patients who did not respond to empirical treatment were switched to second-line treatment of colistin+high dose carbapenem in both groups. The time horizon of the model was five years, with an annual discount rate of 3% applied to both costs and quality-adjusted life-years (QALYs). The analysis demonstrated that an intervention sequence (CAZ-AVI followed by colistin+high dose carbapenem) compared with a comparator sequence (imipenem followed by colistin+high dose carbapenem) was associated with a net incremental cost of (sic)1015 per patient but provided better health outcomes in terms of clinical cure (97.65% vs. 91.08%; Delta = 6.57%), shorter hospital stays (10.65 vs. 12.55 days; Delta = 1.90 days), and QALYs gained per patient (4.190 vs. 4.063; Delta = 0.126). The incremental cost-effectiveness ratio was (sic)8039/QALY, which is well below the willingness-to-pay threshold of (sic)30 000/QALY in Italy. The results showed that CAZ-AVI is expected to be a cost-effective treatment compared with imipenem for cUTI in Italy. (C) 2019 The Authors. Published by Elsevier B.V.

Harvard Citation style: Kongnakorn, T., Wagenlehner, F., Falcone, M., Tichy, E., Di Virgilio, R., Baillon-Plot, N., et al. (2019) Cost-effectiveness analysis of ceftazidime/avibactam compared to imipenem as empirical treatment for complicated urinary tract infections, International Journal of Antimicrobial Agents, 54(5), pp. 633-641. https://doi.org/10.1016/j.ijantimicag.2019.06.008

APA Citation style: Kongnakorn, T., Wagenlehner, F., Falcone, M., Tichy, E., Di Virgilio, R., Baillon-Plot, N., & Charbonneau, C. (2019). Cost-effectiveness analysis of ceftazidime/avibactam compared to imipenem as empirical treatment for complicated urinary tract infections. International Journal of Antimicrobial Agents. 54(5), 633-641. https://doi.org/10.1016/j.ijantimicag.2019.06.008