Cost-effectiveness of imipenem/cilastatin/relebactam for hospital-acquired and ventilator-associated bacterial pneumonia.
Jaesh NaikRyan DillonMatthew MasselloLewis RalphZhuo YangPublished in: Journal of comparative effectiveness research (2023)
Aim: 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'. Methods: 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. Results: 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. Conclusion: 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.
Keyphrases
- risk factors
- case report
- healthcare
- adverse drug
- primary care
- respiratory failure
- acute care
- community acquired pneumonia
- palliative care
- emergency department
- machine learning
- big data
- intensive care unit
- quality improvement
- multidrug resistant
- extracorporeal membrane oxygenation
- combination therapy
- replacement therapy
- gram negative
- mechanical ventilation