Cost-effectiveness analysis of ceftazidime avibactam versus colistin in carbapenem-resistant enterobacteriaceae in Iran
Abstract Introduction Ceftazidime avibactam (CA) is an effective treatment against carbapenem-resistant Enterobacteriaceae (CRE), but its cost-effectiveness is unclear. This study was performed to evaluate the cost-effectiveness of CA against the best available treatment colistin (Col) for patients...
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | Cost Effectiveness and Resource Allocation |
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| Online Access: | https://doi.org/10.1186/s12962-023-00454-8 |
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| author | Zahra Goudarzi Fattaneh Danayi Khosro Keshavarz Ahmad Gholami |
| author_facet | Zahra Goudarzi Fattaneh Danayi Khosro Keshavarz Ahmad Gholami |
| author_sort | Zahra Goudarzi |
| collection | DOAJ |
| description | Abstract Introduction Ceftazidime avibactam (CA) is an effective treatment against carbapenem-resistant Enterobacteriaceae (CRE), but its cost-effectiveness is unclear. This study was performed to evaluate the cost-effectiveness of CA against the best available treatment colistin (Col) for patients with CRE-related infections in Iran. Methodology A model of a decision tree was designed to evaluate the cost-effectiveness of CA in CRE patients over a period of 5 years. The Iran health system was the perspective of the study, and the discount rates of 5.8% and 3% were considered for the data of cost and utility, respectively. The clinical inputs were obtained from a prospective observational study. We established the costs of medical services and medical tariffs of Iran’s health system, and obtained the rate of medical service resources used by patients from specialists. The results of this model included the quality-adjusted life years (QALYs), increasing costs, and incremental cost-utility ratio (ICUR). We also performed the deterministic and probabilistic sensitivity analyses. Results CA reduced the burden of related to treatment failure and the need for treatment of nephrotoxicity and chronic failure, whereas, the costs related to drug procurement and long-term care (due to longer survival) increased. Treatment with CA versus Col resulted in a 53% increase in QALYs and $425 in costs, leading to an ICUR equal to 798 $/QALYs. Sensitivity analyses proved the model’s strength and indicated that the cost-effectiveness of CA can reach 88% when paying 1111 $/QALY. Budget impact analysis estimated CA regimen will increase the health system costs by $1,270,462 in 5 years. Conclusion In Iranian settings, CA can significantly increase the quality of life and patients’ survival; therefore, in comparison to the Col drug regimen, CA is a cost-effective strategy. |
| first_indexed | 2024-03-12T21:08:55Z |
| format | Article |
| id | doaj.art-5665ab15f80b44f586e66dedb1587b39 |
| institution | Directory Open Access Journal |
| issn | 1478-7547 |
| language | English |
| last_indexed | 2024-03-12T21:08:55Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Cost Effectiveness and Resource Allocation |
| spelling | doaj.art-5665ab15f80b44f586e66dedb1587b392023-07-30T11:16:28ZengBMCCost Effectiveness and Resource Allocation1478-75472023-07-012111910.1186/s12962-023-00454-8Cost-effectiveness analysis of ceftazidime avibactam versus colistin in carbapenem-resistant enterobacteriaceae in IranZahra Goudarzi0Fattaneh Danayi1Khosro Keshavarz2Ahmad Gholami3Health Human Resources Research Center, Department of Health Economics, School of Health Management and Information Sciences, Shiraz University of Medical SciencesFaculty of Pharmacy, Shiraz University of Medical SciencesHealth Human Resources Research Center, Department of Health Economics, School of Health Management and Information Sciences, Shiraz University of Medical SciencesPharmaceutical Sciences Research Center, Shiraz University of Medical SciencesAbstract Introduction Ceftazidime avibactam (CA) is an effective treatment against carbapenem-resistant Enterobacteriaceae (CRE), but its cost-effectiveness is unclear. This study was performed to evaluate the cost-effectiveness of CA against the best available treatment colistin (Col) for patients with CRE-related infections in Iran. Methodology A model of a decision tree was designed to evaluate the cost-effectiveness of CA in CRE patients over a period of 5 years. The Iran health system was the perspective of the study, and the discount rates of 5.8% and 3% were considered for the data of cost and utility, respectively. The clinical inputs were obtained from a prospective observational study. We established the costs of medical services and medical tariffs of Iran’s health system, and obtained the rate of medical service resources used by patients from specialists. The results of this model included the quality-adjusted life years (QALYs), increasing costs, and incremental cost-utility ratio (ICUR). We also performed the deterministic and probabilistic sensitivity analyses. Results CA reduced the burden of related to treatment failure and the need for treatment of nephrotoxicity and chronic failure, whereas, the costs related to drug procurement and long-term care (due to longer survival) increased. Treatment with CA versus Col resulted in a 53% increase in QALYs and $425 in costs, leading to an ICUR equal to 798 $/QALYs. Sensitivity analyses proved the model’s strength and indicated that the cost-effectiveness of CA can reach 88% when paying 1111 $/QALY. Budget impact analysis estimated CA regimen will increase the health system costs by $1,270,462 in 5 years. Conclusion In Iranian settings, CA can significantly increase the quality of life and patients’ survival; therefore, in comparison to the Col drug regimen, CA is a cost-effective strategy.https://doi.org/10.1186/s12962-023-00454-8CostEffectivenessCeftazidime avibactamColistinCRE |
| spellingShingle | Zahra Goudarzi Fattaneh Danayi Khosro Keshavarz Ahmad Gholami Cost-effectiveness analysis of ceftazidime avibactam versus colistin in carbapenem-resistant enterobacteriaceae in Iran Cost Effectiveness and Resource Allocation Cost Effectiveness Ceftazidime avibactam Colistin CRE |
| title | Cost-effectiveness analysis of ceftazidime avibactam versus colistin in carbapenem-resistant enterobacteriaceae in Iran |
| title_full | Cost-effectiveness analysis of ceftazidime avibactam versus colistin in carbapenem-resistant enterobacteriaceae in Iran |
| title_fullStr | Cost-effectiveness analysis of ceftazidime avibactam versus colistin in carbapenem-resistant enterobacteriaceae in Iran |
| title_full_unstemmed | Cost-effectiveness analysis of ceftazidime avibactam versus colistin in carbapenem-resistant enterobacteriaceae in Iran |
| title_short | Cost-effectiveness analysis of ceftazidime avibactam versus colistin in carbapenem-resistant enterobacteriaceae in Iran |
| title_sort | cost effectiveness analysis of ceftazidime avibactam versus colistin in carbapenem resistant enterobacteriaceae in iran |
| topic | Cost Effectiveness Ceftazidime avibactam Colistin CRE |
| url | https://doi.org/10.1186/s12962-023-00454-8 |
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