Attanasio E, Russo P, Carunchio G, Basoli A, Caprino L
Department of Experimental Medicine and Pathology, Faculty of Medicine, University of 'La Sapienza', Policlinico Umberto I, Rome, Italy.
Dig Surg. 2000;17(2):164-72. doi: 10.1159/000018822.
The efficacy of two carbapenems, imipenem/cilastatin (I/C, 1.5 g daily) versus meropenem (3 g daily) in intra-abdominal infections was assessed in a recent multicenter randomized clinical trial. The aim of this article is to perform a cost-effectiveness analysis as in real-world practice according to the findings of this clinical trial.
A decision tree was used to estimate the clinical outcomes and direct costs of treating intra-abdominal infections using the two carbapenems from the perspective of the Italian National Health Service (INHS) or a private insurance company (PIC).
In a population of 30,000 patients with intra-abdominal infections in Italy, it was estimated that 97 potential deaths/year could be avoided if these patients were treated with I/C versus meropenem. In addition, from the perspective of INHS, the total costs of treatment were estimated as ITL 106,874 million and 134,042 million for I/C and meropenem, respectively. In favor of the PIC point of view, the total costs were estimated as ITL 110,500 million and 135,899 million for I/C and meropenem, respectively.
The treatment of intra-abdominal infections with I/C is shown to be more effective (97 deaths avoided/year) and less costly than with meropenem (with a saving of ITL 27,168 and 25,399 million/year for INHS and PIC, respectively).
在最近一项多中心随机临床试验中，评估了两种碳青霉烯类药物，即亚胺培南/西司他丁（I/C，每日1.5克）与美罗培南（每日3克）治疗腹腔感染的疗效。本文旨在根据该临床试验的结果，对现实世界中的治疗进行成本效益分析。
采用决策树从意大利国家卫生服务局（INHS）或私人保险公司（PIC）的角度，估计使用这两种碳青霉烯类药物治疗腹腔感染的临床结局和直接成本。
在意大利30,000例腹腔感染患者中，估计如果这些患者接受I/C而非美罗培南治疗，每年可避免97例潜在死亡。此外，从INHS的角度来看，I/C和美罗培南的治疗总成本估计分别为1068.74亿意大利里拉和1340.42亿意大利里拉。从PIC的角度来看，I/C和美罗培南的总成本估计分别为1105.00亿意大利里拉和1358.99亿意大利里拉。
与美罗培南相比，使用I/C治疗腹腔感染更有效（每年可避免97例死亡）且成本更低（INHS和PIC每年分别节省271.68亿和253.99亿意大利里拉）。
