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. 2022 Mar 18:14:149-161.
doi: 10.2147/CEOR.S329494. eCollection 2022.

Ceftaroline Fosamil for the Empiric Treatment of Hospitalized Adults with cSSTI: An Economic Analysis from the Perspective of the Spanish National Health System

Antoni Torres  1 , Alex Soriano  2 , Simone Rivolo  3 , Edit Remak  4 , Carmen Peral  5 , Michal Kantecki  6 , Wajeeha Ansari  7 , Claudie Charbonneau  8 , Jennifer Hammond  9 , Santiago Grau  10 , Mark Wilcox  11
Affiliations

Ceftaroline Fosamil for the Empiric Treatment of Hospitalized Adults with cSSTI: An Economic Analysis from the Perspective of the Spanish National Health System

Antoni Torres et al. Clinicoecon Outcomes Res. .

Abstract

Purpose: Complicated skin and soft tissue infections (cSSTI) are associated with high healthcare resource use and costs. The emergency nature of cSSTI hospitalizations requires starting immediate empiric intravenous (IV) antibiotic treatment, making the appropriate choice of initial antibiotic therapy crucial.

Patients and methods: The use of ceftaroline fosamil (CFT) as an alternative to other IV antibiotic therapies for the empiric treatment of hospitalized adults with cSSTI (vancomycin, linezolid, daptomycin, cloxacillin, tedizolid) was evaluated through cost consequences analysis. The model structure was a decision tree accounting for four different pathways: patients demonstrating early response (ER) either discharged early (with oral antibiotic) or remaining in hospital to continue the initial therapy; non-responders either remaining on the initial IV therapy or switching to a second-line antibiotic. The model perspective was the Spanish National Health System.

Results: CFT resulted in average percentage of patients discharged early (PDE) of 24.6% (CI 19.49-30.2%) with average total cost per patient of €6763 (€6268-€7219). Vancomycin, linezolid, daptomycin and tedizolid resulted in average PDE of 22% (17.34-27.09%), 26.4% (20.5-32.32%), 28.6% (22.08-35.79%) and 26.5% (20.39-33.25%), respectively, for a total cost per patient of €6,619 (€5,902-€6,929), €6,394 (€5,881-€6,904), €6,855 (€5,800-€7,410) and €7,173 (€6,608-€7,763), respectively. Key model drivers were ER and antibiotic treatment duration, with hospital costs accounting for over 83% of the total expenditures.

Conclusion: Given its clinical and safety profile, CFT is an acceptable choice for cSSTI empiric therapy providing comparable ER and costs to other relevant antibiotic options.

Keywords: Spain; ceftaroline fosamil; complicated skin and soft tissue infection; cost-consequences.

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Conflict of interest statement

A.S reports grants, personal fees from Pfizer, during the conduct of the study; personal fees and/or grants from MSD, Shionogi, Angelini, Gilead, and Menarini, outside the submitted work. S.R (an employee of Evidera) and E.R (a former employee of Evidera), were paid consultants to Pfizer in connection with the study and the development of this manuscript. MK, CP, CC, WA, JH are employees of and shareholders in Pfizer. M.W received research funding and consultancy payments from Pfizer for infection topics that are not directly related to this manuscript. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Schematic representation of the decision tree model with the patient pathways described above each branch. The decision-tree probabilities used in the analysis can be found in Table 1.
Figure 2
Figure 2
cSSTI analysis—total costs per patient (A), percentage of early discharges (B) and percentage of patients switched to 2nd line antibiotic (C) predicted by the model (based on 1,000 simulations – 95% confidence intervals estimates provided).
Figure 3
Figure 3
Detailed costs predicted by the model for cSSTI.
Figure 4
Figure 4
Tornado diagram showing, in decreasing order, the key parameters that generated the most variation in the total incremental cost per patient, when comparing ceftaroline fosamil with vancomycin.
See this image and copyright information in PMC

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