Analisi di costo-utilità di ceftolozano/tazobactam rispetto a meropenem in pazienti con polmonite acquisita in ospedale (HABP) o polmonite associata a ventilazione meccanica (VABP)

Abstract

Objective:: This study aims to evaluate the cost-effectiveness of ceftolozane/tazobactam compared to meropenem for the treatment of patients with hospital-acquired pneumonia (HABP) or ventilator-associated pneumonia (VABP) from the Italian National Health Service (NHS) and social perspective.

Method:: A decision tree and a Markov model were developed in order to forecast long-term and short-term disease effects respectively. A hypothetical target population of 1,000 HABP/VABP patients was followed for a lifetime time horizon. In the short-term decision tree, two different settings were developed in order to evaluate the value of empirical therapy compared with the start of treatment after confirmation of the antibiogram. Treated and cured patients enter the long-term Markov model following the mortality of the general population. Direct and indirect costs were considered accordingly with the analysis perspective.

Results:: The analysis showed that ceftolozane/tazobactam, in both treatment settings (empirical and confirmed), may be a cost-effective option compared to meropenem from the NHS and social perspective (ICER equal to € 1,913 and € 2,203 in the empirical treatment setting and € 6,163 and € 6,597 in the confirmed treatment setting for NHS and social perspective respectively).

Conclusions:: Introduction of ceftolozane/tazobactam within the Italian healthcare context can represent a valid therapeutic solution both from an economic and an efficacy profile point of view.

Fig. 1 -

Setting di trattamento iniziale: terapia empirica.

Fig. 2 -

Setting di trattamento confermato dopo antibiogramma.

Fig. 3 -

Struttura del modello di Markov.

Fig. 4 -

Grafico a tornado setting di trattamento empirico (prospettiva SSN).

Fig. 5 -

Grafico a tornado setting di trattamento empirico (prospettiva sociale).

Fig. 6 -

CEAC per ceftolozano/tazobactam nel setting di trattamento empirico (prospettiva SSN).

Fig. 7 -

CEAC per ceftolozano/tazobactam nel setting di trattamento empirico (prospettiva sociale).

Fig. 8 -

Grafico a tornado setting di trattamento confermato (prospettiva SSN).

Fig. 9 -

Grafico a tornado setting di trattamento confermato (prospettiva sociale).

Fig. 10 -

CEAC per ceftolozano/tazobactam nel setting di trattamento confermato (prospettiva SSN).

Fig. 11 -

CEAC per ceftolozano/tazobactam nel setting di trattamento confermato (prospettiva sociale).