Edwards Steven J, Campbell Helen E, Plumb Jonathan M
AstraZeneca UK Ltd, Luton, UK.
Eur J Health Econ. 2006 Mar;7(1):72-8. doi: 10.1007/s10198-005-0333-y.
This study compared the cost-effectiveness of meropenem with that of imipenem plus cilastatin in the treatment of severe infections in hospital intensive care in the UK. A Markov model was constructed to model lifetime costs and quality-adjusted life years (QALYs) of using meropenem and imipenem plus cilastatin for the treatment of severe infections in intensive care. Estimates of effectiveness, utility weights and costs were obtained from the published literature. Probabilistic sensitivity analysis was conducted to assess the robustness of the results. Estimated treatment costs for the patient cohort were pound 14,938 with meropenem and pound 15,585 with imipenem plus cilastatin. QALYs gained were 7,495 with meropenem and 7,413 with imipenem plus cilastatin. Probabilistic sensitivity analysis showed meropenem to be significantly less costly (-pound 636.47, 95% CI -pound 132.33 to -pound 1,140.62) and more effective (0.084, 95% CI 0.023 to 0.144). Meropenem thus appears significantly more effective and less expensive than imipenem plus cilastatin and should therefore be considered the dominant treatment strategy.
本研究比较了美罗培南与亚胺培南西司他丁在英国医院重症监护中治疗严重感染的成本效益。构建了一个马尔可夫模型，以模拟使用美罗培南和亚胺培南西司他丁治疗重症监护中严重感染的终身成本和质量调整生命年（QALYs）。有效性、效用权重和成本的估计值来自已发表的文献。进行了概率敏感性分析以评估结果的稳健性。该患者队列使用美罗培南的估计治疗成本为14,938英镑，使用亚胺培南西司他丁的估计治疗成本为15,585英镑。使用美罗培南获得的QALYs为7,495，使用亚胺培南西司他丁获得的QALYs为7,413。概率敏感性分析表明，美罗培南成本显著更低（-636.47英镑，95%CI -132.33至-1,140.62）且更有效（0.084，95%CI 0.023至0.144）。因此，美罗培南似乎比亚胺培南西司他丁显著更有效且成本更低，因此应被视为主要治疗策略。
