Cost-effectiveness of alternative outpatient pelvic inflammatory disease treatment strategies.
OBJECTIVE
Effectiveness differences between outpatient pelvic inflammatory disease (PID) treatment regimens are uncertain, but significant differences in cost exist.


OBJECTIVE
To examine the influence of antibiotic costs on PID therapy cost-effectiveness.


METHODS
The authors used a Markov decision model to estimate the cost-effectiveness of recommended antibiotic regimens for PID and performed a value of information analysis to guide future research.


RESULTS
Antibiotic costs vary between USD 43 and USD188. Pairwise comparisons, assuming a hypothetical 1% relative risk reduction in PID complications with the more expensive regimen, showed economically reasonable cost-effectiveness ratios. Value of information and sample size considerations support further investigation to detect 10% PID complication rate differences between regimens with >or=USD 50 cost differences.


CONCLUSIONS
Within the cost range of recommended regimens, use of more expensive antibiotics would be economically reasonable if relatively small decreases in PID complication rates exist. Further investigation of effectiveness differences between regimens is needed.
Smith
Kenneth J
KJ
Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. smithkj2@upmc.edu
Ness
Roberta B
RB
Wiesenfeld
Harold C
HC
Roberts
Mark S
MS
D000553:Ambulatory Care / Q000191:economics*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D004318:Doxycycline / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004917:Erythromycin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008390:Markov Chains; D008795:Metronidazole / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D015242:Ofloxacin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D000292:Pelvic Inflammatory Disease / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D008795:Metronidazole; D004917:Erythromycin; D015242:Ofloxacin; D004318:Doxycycline