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COST-EFFECTIVENESS ANALYSIS OF ANTIBOTICS IN THE TREATMENT OF COMPLICATED URINARY TRACT INFECTIONS IN VIETNAM
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Abstract
Background: Ceftazidime/avibactam (CEF/AVI), distinguished for its safety and efficacy, has obtained official approval from both the US Food and Drug Administration [1] and the European Medicines Agency for treating infections caused by multidrug-resistant gram-negative bacteria. This approval extends to complicated urinary tract infections (cUTI), including pyelonephritis [2]. Despite its benefits, the high cost of the drug poses a significant obstacle to its prescription in clinical practice. Research methods: Cost – utility analysis was conducted based on the Vietnamese healthcare insurance payers’ perspective. Input parameters were derived from clinical research, systematic review, and retrospective health insurance payment data in research hospitals and insights gained from consulting with clinical experts. The analysis involved designing a model that simulates the sequential progression of cUTI pathology. Results: CEF/AVI demonstrated an increase in QALY (Quality Adjusted Life Years) from 0.51 to 0.97 QALY compared with other antibiotic regimens for cUTI, including pyelonephritis. Concurrently, costs increased from 46.08 to 56.47 million VND. The incremental cost-effectiveness ratio per QALY gained (ICER/QALY) of CEF/AVI ranged from 58.08 đến 92.64 million VND compared with other regimens for the same indication. Conclusion: From the Vietnamese healthcare payer’s perspective, comparing with the threshold of 1-3 times gross domestic product (GDP) per capita of Vietnam in 2023 (305.7 million VND), CEF/AVI is cost-effective in comparison to comparable interventions for the treatment of cUTI, including pyelonephritis, in Vietnam.
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Keywords
antibiotics, complicated urinary tract infections, cUTI, cost-effectiveness
References
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