Cost-effectiveness of ceftolozane/tazobactam compared with piperacillin/tazobactam as empiric therapy based on the in-vitro surveillance of bacterial isolates in the United States for the treatment of complicated urinary tract infections

BMC Infectious Diseases

Research Article

Goran Medic¹  Jennifer Gaultney¹  Shuvayu S. Sen²  Rebekah H. Borse²  Vimalanand S. Prabhu³  Teresa L Kauf⁴  Benjamin Miller⁵  Anirban Basu⁶ 

[1] MAPI Group, Houten, The Netherlands;Merck & Co., Inc., Kenilworth, NJ, USA;Merck & Co., Inc., Kenilworth, NJ, USA;Merck & Co., Inc., 2000 Galloping Hill Rd., 07033, Kenilworth, NJ, USA;Shire International GmbH, Zug, Switzerland;Shire, Lexington, MA, USA;University of Washington, Seattle, WA, USA;

关键词: Cost-benefit analysis;    Ceftolozane;    Piperacillin;    Tazobactam;    Urinary tract infections;    United States;    Drug resistance;   

DOI  :  10.1186/s12879-017-2408-7

 received in 2017-01-04, accepted in 2017-04-18,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundA challenge in the empiric treatment of complicated urinary tract infection (cUTI) is identifying the initial appropriate antibiotic therapy (IAAT), which is associated with reduced length of stay and mortality compared with initial inappropriate antibiotic therapy (IIAT). We evaluated the cost-effectiveness of ceftolozane/tazobactam compared with piperacillin/tazobactam (one of the standard of care antibiotics), for the treatment of hospitalized patients with cUTI.MethodsA decision-analytic Monte Carlo simulation model was developed to compare the costs and effectiveness of empiric treatment with either ceftolozane/tazobactam or piperacillin/tazobactam in hospitalized adult patients with cUTI infected with Gram-negative pathogens in the US. The model applies the baseline prevalence of resistance as reported by national in-vitro surveillance data.ResultsIn a cohort of 1000 patients, treatment with ceftolozane/tazobactam resulted in higher total costs compared with piperacillin/tazobactam ($36,413 /patient vs. $36,028/patient, respectively), greater quality-adjusted life years (QALYs) (9.19/patient vs. 9.13/patient, respectively) and an incremental cost-effectiveness ratio (ICER) of $6128/QALY. Ceftolozane/tazobactam remained cost-effective at a willingness to pay of $100,000 per QALY compared to piperacillin/tazobactam over a range of input parameter values during one-way and probabilistic sensitivity analysis.ConclusionsModel results show that ceftolozane/tazobactam is likely to be cost-effective compared with piperacillin/tazobactam for the empiric treatment of hospitalized cUTI patients in the United States.

【 授权许可】

CC BY   
© The Author(s). 2017