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COST-EFFECTIVENESS ANALYSIS OF ANTIBOTICS IN THE TREATMENT OF SEPSIS AND HOSPITAL – ACQUIRED PNEUMONIA/ VENTILATOR – ASSOCIATED PNEUMONIA IN VIETNAM
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Abstract
Introduction: Multidrug-resistant gram-negative infections are the primary cause of severe diseases, including hospital-acquired pneumonia/ventilator-associated pneumonia (HAP/VAP) and sepsis. The ceftazidime/avibactam (CEF/AVI) regimen has been proven effective and safe in treating sepsis and HAP/VAP. However, the high treatment cost limits its selection in clinical practice. Therefore, a cost-effectiveness analysis (CEA) of CEF/AVI compared to other antibiotic regimens in treating sepsis and HAP/VAP is necessary to provide a scientific basis for reimbursement decisions in Vietnam. Research methods: Cost-utility analysis was conducted using a sequential simulation model of multidrug-resistant gram-negative infections from the perspective of the health insurance payer. Input parameters were sourced from clinical studies, systematic reviews, and expert clinical opinions. Results: The ICER/QALY of CEF/AVI ranged from 65.22 million VND to 114.17 million VND for HAP/VAP treatment and from 39.97 million VND to 83.22 million VND for sepsis treatment compared to the comparator interventions. Conclusion: From the perspective of third-party payers, compared to the willingness-to-pay threshold of three times the GDP per capita in 2023 (305.7 million VND), CEF/AVI was cost-effective compared to meropenem, imipenem, piperacillin/tazobactam, and colistin+high-dose carbapenem for treating HAP/VAP and cost-effective compared to amikacin+high-dose carbapenem and colistin+high-dose carbapenem for treating sepsis. This study may support policymakers in considering reimbursement for CEF/AVI in treating sepsis and HAP/VAP in Vietnam.
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Keywords
Cost-effectiveness, antibiotics, sepsis, hospital-acquired pneumonia, ventilator-associated pneumonia, Vietnam.
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