Pharmacoeconomic evaluation of linezolid versus teicoplanin in bacteremia by Gram-positive microorganisms.
OBJECTIVE
The objective of this study was to compare the efficiency of linezolid versus teicoplanin in the treatment of bacteremia produced by Gram-positive microorganisms through a pharmacoeconomic analysis based on clinical results obtained from a previous clinical trial.


METHODS
We applied an analysis of cost-effectiveness elaborated through a pharmacoeconomic model. We defined each unit of effectiveness as 'each successfully cured of infections with bacteremia.' We used the program Pharma-Decision (version Hospital 1.1) that allows to build interactive pharmacoeconomic models. Effectiveness data of both antibiotics were obtained from a published clinical trial, while resources consumed were obtained from the same source and from a consensus provided by a local expert panel. Only direct costs were included in the analysis without taking into consideration indirect costs. The perspective chosen was hospital assistance and the time horizon was set to 28 days. All costs are expressed in Euros.


RESULTS
Linezolid demonstrated a better clinical outcome with less associated costs compared to teicoplanin (88.5 versus 56.7% of cured patients and 5,557.04 versus 6,327.43 <euro> per treated patient, respectively), thus resulting in a lower cost-effectiveness ratio for linezolid versus teicoplanin (6,279.1 versus 11,159.5 <euro> per cured patient with a 95% CI of 5,960.2-6,510.4 and 10,865.2-12,647.3, respectively) which results in a the dominant position for linezolid. The sensitivity analysis showed that linezolid was always the most efficient option even when modifying the value of variables with higher uncertainty.


CONCLUSIONS
Linezolid is a more efficient option than teicoplanin because it presents higher rate of effectiveness with lower consumption of resources, thus being a dominant alternative in the treatment of Gram-positive infection with bacteremia.
Grau
Santiago
S
Pharmacy Department, Hospital del Mar, Passeig Marítim, 25-29, 08003, Barcelona, Spain. sgrau@imas.imim.es
Mateu-de Antonio
Javier
J
Soto
Javier
J
Marín-Casino
Mónica
M
Salas
Esther
E
D000081:Acetamides / Q000191:economics* / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000191:economics* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000191:economics*; D017721:Hospital Costs; D006801:Humans; D000069349:Linezolid; D018803:Models, Economic; D023303:Oxazolidinones / Q000191:economics* / Q000627:therapeutic use; D017334:Teicoplanin / Q000191:economics* / Q000627:therapeutic use
D000081:Acetamides; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D017334:Teicoplanin; D000069349:Linezolid