title: [Pharmacoeconomic analysis of community-acquired pneumonia treatment with telithromycin or clarithromycin].
abstract: A pharmacoeconomic analysis was carried out comparing the efficacy of two treatment options for community-acquired pneumonia (CAP): telithromycin and clarithromycin. It was a retrospective analysis using a decision tree model. The efficacy of the two treatment options was estimated from a randomized, double-blind clinical trial, in which 800 mg/day oral telithromycin for 10 days was compared to 1000 mg/day oral clarithromycin for 10 days in patients with CAP (162 and 156 respectively). The use of resources was estimated based on the clinical trial and Spanish sources, and the unit costs from a Spanish health costs database. Costs were evaluated for the acquisition of antibiotic treatments, change of antibiotic due to therapeutic failure, hospital admissions, adverse reactions to treatment, primary care visits, tests and indirect costs (working days lost). The model was validated by a panel of Spanish clinical experts. As the clinical trial was designed to show equivalence, there were no significant differences in efficacy between the treatment options (clinical cure rate 88.3% and 88.5%, respectively), and a cost minimization analysis was performed. In the base case, the average cost of the disease per patient was 308.29 euros with telithromycin and 331.5 euros with clarithromycin (a difference of 23.21 euros). The results were stable in the susceptibility analysis, with differences favorable to telithromycin ranging between 5.50 and 45.45 euros. Telithromycin results in a cost savings of up to 45.45 euros per CAP patient compared to clarithromycin.
authors.affiliation: HERO Consulting, Health Economics and Research of Outcomes, Madrid, Spain. carlosrubio@wanadoo.es
authors.forename: C
authors.initials: C
authors.lastname: Rubio-Terrés
authors.forename: J M
authors.initials: JM
authors.lastname: Cots
authors.forename: A
authors.initials: A
authors.lastname: Domínguez-Gil
authors.forename: A
authors.initials: A
authors.lastname: Herreras
authors.forename: F
authors.initials: F
authors.lastname: Sánchez Gascón
authors.forename: J
authors.initials: J
authors.lastname: Chang
authors.forename: A
authors.initials: A
authors.lastname: Trilla
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use*; D017291:Clarithromycin / Q000191:economics* / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000191:economics; D003365:Costs and Cost Analysis; D003663:Decision Trees; D017850:Economics, Pharmaceutical; D006801:Humans; D048628:Ketolides; D018942:Macrolides / Q000191:economics* / Q000627:therapeutic use*; D011014:Pneumonia / Q000188:drug therapy* / Q000191:economics*; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D048628:Ketolides; D018942:Macrolides; D017291:Clarithromycin; C106791:telithromycin