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Cost-effectiveness study of imipenem/cilastatin versus meropenem in intra-abdominal infections
E Attanasio1, P Russo, G Carunchio
1Department of Experimental Medicine and Pathology, Faculty of Medicine, University of 'La Sapienza', Policlinico Umberto I, Rome, Italy.
Background:
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.
Methods:
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).
Results:
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.
Conclusion:
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).
Insights
Imipenem/cilastatin (I/C) treatment for intra-abdominal infections is more effective, avoiding 97 deaths annually compared to meropenem. This carbapenem therapy also proves more cost-effective for both the Italian National Health Service and private insurance.
Area of Science:
- Infectious Diseases
- Pharmacoeconomics
- Clinical Trial Analysis
Background:
- A multicenter randomized clinical trial compared the efficacy of imipenem/cilastatin (I/C) at 1.5 g daily versus meropenem at 3 g daily for intra-abdominal infections.
- The study aimed to assess the cost-effectiveness of these two carbapenems in a real-world setting based on the clinical trial findings.
Purpose of the Study:
- To conduct a cost-effectiveness analysis of imipenem/cilastatin versus meropenem for treating intra-abdominal infections.
- To evaluate treatment outcomes and direct costs from the perspectives of the Italian National Health Service (INHS) and a private insurance company (PIC).
Main Methods:
- A decision tree model was employed to estimate clinical outcomes and direct treatment costs.
- The analysis considered the Italian healthcare context, evaluating both public (INHS) and private (PIC) payer perspectives.
Main Results:
- In a hypothetical population of 30,000 patients, imipenem/cilastatin (I/C) could potentially avoid 97 deaths annually compared to meropenem.
- Total treatment costs favored I/C: ITL 106,874 million (INHS) vs. ITL 134,042 million (meropenem) and ITL 110,500 million (INHS) vs. ITL 135,899 million (meropenem) for PIC.
- I/C demonstrated significant cost savings of ITL 27,168 million/year for INHS and ITL 25,399 million/year for PIC compared to meropenem.
Conclusions:
- Imipenem/cilastatin (I/C) is a more effective treatment for intra-abdominal infections, associated with a substantial reduction in mortality.
- I/C offers superior cost-effectiveness compared to meropenem, resulting in significant financial savings for both public and private healthcare payers in Italy.