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dc.creatorSalavert, Migueles
dc.creatorPascual Hernández, Álvaroes
dc.creatorCobo, Javieres
dc.creatorAragón, Belénes
dc.creatorMaratia, Stefanoes
dc.creatorAceituno, Susanaes
dc.creatorGrau, Santiagoes
dc.date.accessioned2018-12-03T11:00:51Z
dc.date.available2018-12-03T11:00:51Z
dc.date.issued2018
dc.identifier.citationSalavert, M., Pascual Hernández, Á., Cobo, J., Aragón, B., Maratia, S., Aceituno, S. y Grau, S. (2018). Cost-Effectiveness Analysis of Bezlotoxumab Added to Standard of Care Versus Standard of Care Alone for the Prevention of Recurrent Clostridium difficile Infection in High-Risk Patients in Spain. Advances in Therapy, 35 (11), 1920-1934.
dc.identifier.issn1865-8652es
dc.identifier.urihttps://hdl.handle.net/11441/80741
dc.description.abstractIntroduction Clostridium difficile infection (CDI) is the major cause of infectious nosocomial diarrhoea and is associated with considerable morbidity, mortality and economic impact. Bezlotoxumab administered in combination with standard of care (SoC) antibiotic therapy prevents recurrent CDI. This study assessed the cost-effectiveness of bezlotoxumab added to SoC, compared to SoC alone, to prevent the recurrence of CDI in high-risk patients from the Spanish National Health System perspective. Methods A Markov model was used to simulate the natural history of CDI over a lifetime horizon in five populations of patients at high risk of CDI recurrence according to MODIFY trials: (1) ≥ 65 years old; (2) severe CDI; (3) immunocompromised; (4) ≥ 1 CDI episode in the previous 6 months; and (5) ≥ 65 years old and with ≥ 1 CDI episode in the previous 6 months. The incremental cost-effectiveness ratio (ICER) expressed as cost per quality-adjusted life-year (QALY) gained was calculated. Deterministic (DSA) and probabilistic sensitivity analyses (PSA) were performed. Results In all patient populations (from 1 to 5), bezlotoxumab added to SoC reduced CDI recurrence compared to SoC alone by 26.4, 19.5, 21.2, 26.6 and 39.7%, respectively. The resulting ICERs for the respective subgroups were €12,724, €17,495, €9545, €7386, and €4378. The model parameters with highest impact on the ICER were recurrence rate (first), mortality, and utility values. The probability that bezlotoxumab was cost-effective at a willingness-to-pay threshold of €21,000/QALY was 85.5%, 54.1%, 86.0%, 94.5%, 99.6%, respectively. Conclusion The results suggest that bezlotoxumab added to SoC compared to SoC alone is a cost-effective treatment to prevent the recurrence of CDI in high-risk patients. The influence of changes in model parameters on DSA results was higher in patients  ≥ 65 years old, with severe CDI and immunocompromised. Additionally, PSA estimated that the probability of cost-effectiveness exceeded 85% in most subgroups.es
dc.formatapplication/pdfes
dc.language.isoenges
dc.publisherSpringeres
dc.relation.ispartofAdvances in Therapy, 35 (11), 1920-1934.
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectBezlotoxumabes
dc.subjectClostridium difficile infectiones
dc.subjectCost-effectivenesses
dc.titleCost-Effectiveness Analysis of Bezlotoxumab Added to Standard of Care Versus Standard of Care Alone for the Prevention of Recurrent Clostridium difficile Infection in High-Risk Patients in Spaines
dc.typeinfo:eu-repo/semantics/articlees
dc.type.versioninfo:eu-repo/semantics/publishedVersiones
dc.rights.accessrightsinfo:eu-repo/semantics/openAccesses
dc.contributor.affiliationUniversidad de Sevilla. Departamento de Microbiologíaes
dc.relation.publisherversionhttp://dx.doi.org/10.1007/s12325-018-0813-yes
dc.identifier.doi10.1007/s12325-018-0813-yes
idus.format.extent14 p.es
dc.journaltitleAdvances in Therapyes
dc.publication.volumen35es
dc.publication.issue11es
dc.publication.initialPage1920es
dc.publication.endPage1934es

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Attribution-NonCommercial-NoDerivatives 4.0 Internacional
Except where otherwise noted, this item's license is described as: Attribution-NonCommercial-NoDerivatives 4.0 Internacional