Rittenhouse B E, Stinnett A A, Dulisse B, Henke C J, Potter L, Parasuraman B, Martens L L, Williams R R, Kojak C
ICOM Health Care Economics, Johnson & Johnson, Raritan, NJ 08869-0602, USA.
Am J Manag Care. 2000 Mar;6(3):381-9.
To examine treatment costs of community-acquired pneumonia (CAP) in adult outpatients given oral (p.o.) levofloxacin or cefuroxime axetil as initial therapy.
Patients with a primary diagnosis of CAP were enrolled in a multicenter, prospective, randomized, open-label, active-controlled Phase III clinical trial. Both inpatients and outpatients were assigned to 1 of 2 treatment groups: (1) intravenous (i.v.) or p.o. levofloxacin; or (2) i.v. ceftriaxone and/or p.o. cefuroxime axetil.
To make legitimate and meaningful cost comparisons between similar types of patients receiving drugs via the same route of administration (i.e., orally), this outpatient economic study examined the resource utilization of the 211 patients enrolled as outpatients who received oral formulations as initial treatment (levofloxacin, 103 patients; cefuroxime axetil, 108 patients). Resource utilization data and clinical trial data were collected concurrently. To generate cost estimates, Medicare cost estimates for resources were multiplied by the resource units used by patients in each treatment arm.
Cost estimates indicated a total cost difference that favored the levofloxacin group (base case: $169; sensitivity analysis: $223 [P = .008]). The results for the base case were not significant (P = .094). In addition, within the cost categories, there was a statistically significant study drug cost differential favoring levofloxacin ($86; P = .0001 for both the base case and sensitivity analysis).
Oral levofloxacin is less costly than oral cefuroxime axetil in the outpatient treatment of adults with CAP.
研究以口服左氧氟沙星或头孢呋辛酯作为初始治疗方案时，成年门诊社区获得性肺炎（CAP）患者的治疗费用。
将初诊为CAP的患者纳入一项多中心、前瞻性、随机、开放标签、活性对照的III期临床试验。住院患者和门诊患者均被分配至2个治疗组之一：（1）静脉注射（i.v.）或口服左氧氟沙星；或（2）静脉注射头孢曲松和/或口服头孢呋辛酯。
为了对通过相同给药途径（即口服）接受药物治疗的相似类型患者进行合理且有意义的成本比较，这项门诊经济学研究考察了211例接受口服制剂作为初始治疗的门诊入组患者（左氧氟沙星组103例；头孢呋辛酯组108例）的资源利用情况。资源利用数据和临床试验数据同时收集。为了生成成本估算，将每种资源的医疗保险成本估算值乘以每个治疗组患者使用的资源单位数。
成本估算显示总成本差异有利于左氧氟沙星组（基础病例：169美元；敏感性分析：223美元[P = 0.008]）。基础病例结果无统计学意义（P = 0.094）。此外，在成本类别中，研究药物成本差异具有统计学意义，有利于左氧氟沙星（86美元；基础病例和敏感性分析的P值均为0.0001）。
在成年CAP门诊患者的治疗中，口服左氧氟沙星的成本低于口服头孢呋辛酯。
