PHÂN TÍCH CHI PHÍ – HỆ QUẢ CỦA CEFTAROLINE FOSAMIL TRONG ĐIỀU TRỊ NHIIỄM TRÙNG DA – MÔ MỀM CÓ BIẾN CHỨNG Ở NGƯỜI LỚN TẠI VIỆT NAM

Abstract

Objectives: Analyzing the costs and consequences associated with treating complicated skin and soft tissue infections in adult patients using Ceftaroline in comparison to empirically prescribed antibiotics during hospitalization in Vietnam. Materials and Methodology: The decision tree model was applied for cost-consequence analysis. adopting the perspective of Health Insurance. The analysis duration extended from the day of inpatient admission to the hospital until the discharge date. Results and Discussions: Results of the cost-consequence analysis showed that the overall clinical cure rate for patients initiating treatments with Ceftaroline and comparators were similar (ranging from 95% to 99%). The average total costs per patient varied significantly (Ceftaroline is approximately 3.5 million higher than Vancomycin + Carbapenem and but 4 - 9 million lower than other newer antibiotics). From the payer's perspective, initiating treatment with Ceftaroline increases the clinical cure rate and increases the average total treatment cost compared to Vancomycin + Carbapenem and Clindamycin + Carbapenem; Ceftaroline is superior to Tigecycline; providing cost-savings but slightly reducing the clinical cure rate compared to Linezolid + Carbapenem. The key factors that influence the difference in costs and outcomes are the duration of treatment with Ceftaroline and the comparative antibiotic for costs, and the clinical cure rate when initiating with Ceftaroline for outcomes. Probabilistic sensitivity analysis also indicates the probability of cost savings with Ceftaroline compared to using Vancomycin 1g q12h + Carbapenem 500mg q8h, Linezolid 600mg q12h + Carbapenem 500mg q8h, Clindamycin 600mg q8h + Carbapenem 500mg q8h, Tigecyclin 50mg q12h are 23.4%, 85.9%, 14.5% and 73.3% respectively. Conclusion: Ceftaroline is a potential new antibiotic in the treatment of skin and soft tissue infections with greater effectiveness than commonly used antibiotics. The added cost of Ceftaroline needs to be considered in the context of increasing antibiotic resistance rate and the need to ensure the availability of antibiotics in the medicine lists.