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亚胺培南/西司他丁/雷巴他定治疗医院获得性和呼吸机相关性细菌性肺炎的成本效益。

Cost-effectiveness of imipenem/cilastatin/relebactam for hospital-acquired and ventilator-associated bacterial pneumonia.

机构信息

BresMed Health Solutions Ltd, Sheffield,S1 2GQ, UK.

Merck & Co., Inc., Rahway, NJ 07065, USA.

出版信息

J Comp Eff Res. 2023 Mar;12(3):e220113. doi: 10.2217/cer-2022-0113. Epub 2023 Jan 23.

DOI:10.2217/cer-2022-0113
PMID:36688591
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10288960/
Abstract

This study evaluates the cost-effectiveness of imipenem/cilastatin/relebactam (IMI/REL) for treating hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP) in an 'early adjustment prescribing scenario'. An economic model was constructed to compare two strategies: continuation of empiric piperacillin/tazobactam (PIP/TAZ) versus early adjustment to IMI/REL. A decision tree was used to depict the hospitalization period, and a Markov model used to capture long-term outcomes. IMI/REL generated more quality-adjusted life years than PIP/TAZ, at an increased cost per patient. The incremental cost-effectiveness ratio of $17,529 per QALY is below the typical US willingness-to-pay threshold. IMI/REL may represent a cost-effective treatment for payers and a valuable option for clinicians, when considered alongside patient risk factors, local epidemiology, and susceptibility data.

摘要

本研究评估了亚胺培南/西司他丁/雷巴他定（IMI/REL）在“早期调整处方方案”下治疗医院获得性细菌性肺炎和呼吸机相关性细菌性肺炎（HABP/VABP）的成本效益。构建了一个经济模型来比较两种策略：继续使用经验性哌拉西林/他唑巴坦（PIP/TAZ）与早期调整为 IMI/REL。决策树用于描述住院期间，马尔可夫模型用于捕捉长期结果。与 PIP/TAZ 相比，IMI/REL 产生了更多的质量调整生命年，但每个患者的成本增加。增量成本效益比为每 QALY 17529 美元，低于美国通常的支付意愿阈值。当考虑患者的风险因素、当地的流行病学和药敏数据时，IMI/REL 可能是支付者的一种具有成本效益的治疗方法，也是临床医生的一个有价值的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b71/10288960/61a5b70c860e/cer-12-220113-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b71/10288960/3c7b5a6a2604/cer-12-220113-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b71/10288960/a82b0d9afa38/cer-12-220113-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b71/10288960/3b6d047a12a5/cer-12-220113-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b71/10288960/61a5b70c860e/cer-12-220113-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b71/10288960/3c7b5a6a2604/cer-12-220113-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b71/10288960/a82b0d9afa38/cer-12-220113-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b71/10288960/3b6d047a12a5/cer-12-220113-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b71/10288960/61a5b70c860e/cer-12-220113-g4.jpg

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