Cost-Effectiveness Analysis of Linezolid, Daptomycin, and Vancomycin in Methicillin-Resistant Staphylococcus aureus: Complicated Skin and Skin Structure Infection Using Bayesian Methods for Evidence Synthesis

Autor: Mark Bounthavong, David J. Vanness, Amir H. Zargarzadeh, Donald I. Hsu
Rok vydání: 2011
Předmět:
Cost-Benefit Analysis
medicine.disease_cause
chemistry.chemical_compound
Anti-Infective Agents
Acetamides
polycyclic compounds
Hospital Costs
Aged
80 and over
Skin and skin structure infection
Health Policy
cost-effectiveness analysis
complicated skin and skin structure infections
Middle Aged
Models
Economic
Outcome and Process Assessment
Health Care
Treatment Outcome
Staphylococcus aureus
Vancomycin
Drug Therapy
Combination
Staphylococcal Skin Infections
lipids (amino acids
peptides
and proteins)
Health Services Research
medicine.drug
Adult
Methicillin-Resistant Staphylococcus aureus
medicine.medical_specialty
Bayesian methods
Adolescent
Drug Costs
Decision Support Techniques
Young Adult
Pharmacotherapy
Daptomycin
Internal medicine
medicine
Humans
Adverse effect
decision analysis model
Oxazolidinones
Aged
Diagnostic Tests
Routine
business.industry
Linezolid
Public Health
Environmental and Occupational Health
Bayes Theorem
biochemical phenomena
metabolism
and nutrition
bacterial infections and mycoses
Methicillin-resistant Staphylococcus aureus
United States
Surgery
chemistry
business
Zdroj: Value in Health. 14(5):631-639
ISSN: 1098-3015
DOI: 10.1016/j.jval.2010.12.006
Popis: Background Methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and skin structure infection (cSSSI) is a prominent infection encountered in hospital and outpatient settings that is associated with high resource use for the health-care system. Objective A decision analytic (DA) model was developed to evaluate the cost-effectiveness analysis (CEA) of linezolid, daptomycin, and vancomycin in MRSA cSSSI. Methods Bayesian methods for evidence synthesis were used to generate efficacy and safety parameters for a DA model using published clinical trials. CEA was done from the US health-care perspective. Efficacy was defined as a successfully treated patient at the test of cure without any adverse reaction. Primary outcome was the incremental cost-effectiveness ratio between linezolid and vancomycin, daptomycin and vancomycin, and linezolid and daptomycin in MRSA cSSSI. Univariate and probabilistic sensitivity analyses were performed to test the robustness of the model. Results The total direct costs of linezolid, daptomycin, and vancomycin were $18,057, $20,698, and $23,671, respectively. The cost-effectiveness ratios for linezolid, daptomycin, and vancomycin were $37,604, $44,086, and $52,663 per successfully treated patient, respectively. Linezolid and daptomycin were dominant strategies compared to vancomycin. However, linezolid was dominant when compared to daptomycin. The model was sensitive to the duration of daptomycin and linezolid treatment. Conclusion Linezolid and daptomycin are potentially cost-effective based on the assumptions of the DA model; however, linezolid appears to be more cost-effective compared to daptomycin and vancomycin for MRSA cSSSIs.
Databáze: OpenAIRE
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