Cost saving of 5-day therapy with cefpodoxime proxetil versus standard 10-day beta-lactam therapy for recurrent pharyngotonsillitis in adults. A prospective general practice study.
A prospective economic evaluation was undertaken as part of a randomised clinical trial conducted in French general practice. Its aim was to compare the costs and therapeutic outcomes of a 5-day course of cefpodoxime proxetil 100 mg twice daily with 10-day courses of phenoxymethylpenicillin (penicillin V) 1 MIU 3 times daily and amoxicillin-clavulanic acid 500/125 mg 3 times daily for the treatment of recurrent pharyngotonsillitis in 575 adults. Over the 6-month study period, the total cost to society per patient treated with cefpodoxime proxetil was 123 French francs (FF; 1993 values) lower than that for patients treated with phenoxymethylpenicillin and FF227 lower than that for patients treated with amoxicillin-clavulanic acid. This cost saving was primarily attributable to a lower initial drug acquisition cost, and a reduction in the cost associated with lost productivity and general practitioner consultations. Furthermore, as a consequence of a lower relapse rate, the cost-saving ratio for cefpodoxime proxetil, expressed as FF per month free of recurrence, was FF50 less than for phenoxymethylpenicillin and FF60 less than for amoxicillin-clavulanic acid. Thus, a 5-day course of cefpodoxime proxetil is likely to be less costly for treatment of pharyngotonsillitis in the general practice setting than standard 10-day courses of phenoxymethylpenicillin and amoxicillin-clavulanic acid.
Pelc
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Health Economics Department, IMS International, Montrouge, France.
Portier
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H
Gehanno
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Fiessinger
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S
Ichou
F
F
D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use; D015296:Ceftizoxime / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D019818:Clavulanic Acid; D002969:Clavulanic Acids / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination / Q000191:economics* / Q000627:therapeutic use; D005194:Family Practice; D005602:France; D006801:Humans; D010404:Penicillin V / Q000191:economics / Q000627:therapeutic use; D010612:Pharyngitis / Q000188:drug therapy* / Q000191:economics; D011355:Prodrugs / Q000191:economics* / Q000627:therapeutic use; D012008:Recurrence; D014069:Tonsillitis / Q000188:drug therapy* / Q000191:economics; D016896:Treatment Outcome; D000097627:Cefpodoxime Proxetil