Economic analysis of ceftaroline fosamil for treating community-acquired pneumonia in Spain

Torres, Antoni; Bassetti, Matteo; Welte, Tobias; Rivolo, Simone; Remak, Edit; Peral, Carmen; Charbonneau, Claudie; Hammond, Jennifer; Ansari, Wajeeha; Grau Cerrato, Santiago

doi:http://dx.doi.org/10.1080/13696998.2019.1688819

Economic analysis of ceftaroline fosamil for treating community-acquired pneumonia in Spain

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Torres A, Bassetti M, Welte T, Rivolo S, Remak E, Peral C, et al. Economic analysis of ceftaroline fosamil for treating community-acquired pneumonia in Spain. J Med Econ. 2020 Feb; 23(2): 148-55. DOI: 10.1080/13696998.2019.1688819

Abstract

Background: Adults admitted to hospital with community-acquired pneumonia (CAP) impose significant burden upon limited hospital resources. To achieve early response and possibly early discharge, thus reducing hospital expenditure, the choice of initial antibiotic therapy is pivotal.Methods: A cost-consequences model was developed to evaluate ceftaroline fosamil (CFT) as an alternative to other antibiotic therapies (ceftriaxone, co-amoxiclav, moxifloxacin, levofloxacin) for the empiric treatment of hospitalized adults with moderate/severe CAP (PORT score III-IV) from the perspective of the Spanish National Health System (NHS).Findings: Compared with ceftriaxone, the model predicted an increase in the number of CFT-treated patients discharged early (PDE) (30.6% vs. 26.1%) while decreasing initial antibiotic failures (3.8% vs. 7.6%). For patients with pneumococcal pneumonia, CFT was cost-saving vs. ceftriaxone (by 1.2%) and significantly increased PDE (32.1% vs. 24.6%). CFT resulted in cost-saving vs. levofloxacin, due lower initial antibiotic therapy costs and increased PDE (30.6% vs. 14.9%). Moxifloxacin and co-amoxiclav early response rate of 53.63% and 54.24% resulted in cost neutrality vs. CFT, with direct comparison hampered by the significantly different early response criteria utilized in the literature.Conclusions: Despite a higher unit cost, CFT is a reasonable alternative to other agents for adults hospitalized with moderate/severe CAP, given the projected higher PDE achieved with similar or lower total costs.