Cost-effectiveness study of imipenem/cilastatin versus meropenem in intra-abdominal infections.
BACKGROUND
The efficacy of two carbapenems, imipenem/cilastatin (I/C, 1.5 g daily) versus meropenem (3 g daily) in intra-abdominal infections was assessed in a recent multicenter randomized clinical trial. The aim of this article is to perform a cost-effectiveness analysis as in real-world practice according to the findings of this clinical trial.


METHODS
A decision tree was used to estimate the clinical outcomes and direct costs of treating intra-abdominal infections using the two carbapenems from the perspective of the Italian National Health Service (INHS) or a private insurance company (PIC).


RESULTS
In a population of 30,000 patients with intra-abdominal infections in Italy, it was estimated that 97 potential deaths/year could be avoided if these patients were treated with I/C versus meropenem. In addition, from the perspective of INHS, the total costs of treatment were estimated as ITL 106,874 million and 134,042 million for I/C and meropenem, respectively. In favor of the PIC point of view, the total costs were estimated as ITL 110,500 million and 135,899 million for I/C and meropenem, respectively.


CONCLUSIONS
The treatment of intra-abdominal infections with I/C is shown to be more effective (97 deaths avoided/year) and less costly than with meropenem (with a saving of ITL 27,168 and 25,399 million/year for INHS and PIC, respectively).
Attanasio
E
E
Department of Experimental Medicine and Pathology, Faculty of Medicine, University of 'La Sapienza', Policlinico Umberto I, Rome, Italy.
Russo
P
P
Carunchio
G
G
Basoli
A
A
Caprino
L
L
D018806:APACHE; D015377:Cilastatin / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D004338:Drug Combinations; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015378:Imipenem / Q000191:economics / Q000627:therapeutic use*; D007239:Infections / Q000188:drug therapy* / Q000191:economics; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000188:drug therapy* / Q000191:economics; D011480:Protease Inhibitors / Q000191:economics / Q000627:therapeutic use; D013845:Thienamycins / Q000191:economics / Q000627:therapeutic use*
D004338:Drug Combinations; D011480:Protease Inhibitors; D013845:Thienamycins; D015377:Cilastatin; D015378:Imipenem; D000077731:Meropenem