Cost-Utility Analysis Comparing Meropenem with Imipenem Plus Cilastatin in the Treatment of Severe Infections in Intensive Care

This study compared the cost-effectiveness of meropenem with that of imipenem plus cilastatin in the treatment of severe infections in hospital intensive care in the UK. A Markov model was constructed to model lifetime costs and quality-adjusted life years (QALYs) of using meropenem and imipenem plu...

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Bibliographic Details
Published in:The European journal of health economics 2006-03, Vol.7 (1), p.72-78
Main Authors: Edwards, Steven J., Campbell, Helen E., Plumb, Jonathan M.
Format: Article
Language:English
Subjects:
Aged
Anti-Bacterial Agents - economics
Anti-Bacterial Agents - therapeutic use
Bacterial Infections - drug therapy
Cilastatin - economics
Cilastatin - therapeutic use
Cohort Studies
Cost analysis
Cost efficiency
Cost-Benefit Analysis
Costs
Decision Support Techniques
Dipeptidases - antagonists & inhibitors
Drug Combinations
Economic costs
Economic models
Female
Health economics
Humans
Infections
Intensive care
Intensive care units
Intensive Care Units - economics
Male
Markov Chains
Middle Aged
Mortality
Original Papers
Quality-Adjusted Life Years
Sensitivity analysis
Sensitivity and Specificity
Studies
Thienamycins - economics
Thienamycins - therapeutic use
Utilities costs
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Summary:This study compared the cost-effectiveness of meropenem with that of imipenem plus cilastatin in the treatment of severe infections in hospital intensive care in the UK. A Markov model was constructed to model lifetime costs and quality-adjusted life years (QALYs) of using meropenem and imipenem plus cilastatin for the treatment of severe infections in intensive care. Estimates of effectiveness, utility weights and costs were obtained from the published literature. Probabilistic sensitivity analysis was conducted to assess the robustness of the results. Estimated treatment costs for the patient cohort were £14,938 with meropenem and £15,585 with imipenem plus cilastatin. QALYs gained were 7,495 with meropenem and 7,413 with imipenem plus cilastatin. Probabilistic sensitivity analysis showed meropenem to be significantly less costly (-£636.47, 95% Cl -£132.33 to -£1,140.62) and more effective (0.084, 95% Cl 0.023 to 0.144). Meropenem thus appears significantly more effective and less expensive than imipenem plus cilastatin and should therefore be considered the dominant treatment strategy.
ISSN:1618-7598
1618-7601
DOI:10.1007/s10198-005-0333-y