title: Cost-effectiveness in Clostridium difficile treatment decision-making.
abstract: OBJECTIVE
  To develop a framework for the clinical and health economic assessment for management of Clostridium difficile infection (CDI).
  
  
  METHODS
  CDI has vast economic consequences emphasizing the need for innovative and cost effective solutions, which were aim of this study. A guidance model was developed for coverage decisions and guideline development in CDI. The model included pharmacotherapy with oral metronidazole or oral vancomycin, which is the mainstay for pharmacological treatment of CDI and is recommended by most treatment guidelines.
  
  
  RESULTS
  A design for a patient-based cost-effectiveness model was developed, which can be used to estimate the cost-effectiveness of current and future treatment strategies in CDI. Patient-based outcomes were extrapolated to the population by including factors like, e.g., person-to-person transmission, isolation precautions and closing and cleaning wards of hospitals.
  
  
  CONCLUSIONS
  The proposed framework for a population-based CDI model may be used for clinical and health economic assessments of CDI guidelines and coverage decisions for emerging treatments for CDI.
authors.affiliation: Mark JC Nuijten, Ars Accessus Medica, 1546 LG Jisp, The Netherlands.
authors.forename: Mark Jc
authors.initials: MJ
authors.lastname: Nuijten
authors.affiliation: Mark JC Nuijten, Ars Accessus Medica, 1546 LG Jisp, The Netherlands.
authors.forename: Josbert J
authors.initials: JJ
authors.lastname: Keller
authors.affiliation: Mark JC Nuijten, Ars Accessus Medica, 1546 LG Jisp, The Netherlands.
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Visser
authors.affiliation: Mark JC Nuijten, Ars Accessus Medica, 1546 LG Jisp, The Netherlands.
authors.forename: Ken
authors.initials: K
authors.lastname: Redekop
authors.affiliation: Mark JC Nuijten, Ars Accessus Medica, 1546 LG Jisp, The Netherlands.
authors.forename: Eric
authors.initials: E
authors.lastname: Claassen
authors.affiliation: Mark JC Nuijten, Ars Accessus Medica, 1546 LG Jisp, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Speelman
authors.affiliation: Mark JC Nuijten, Ars Accessus Medica, 1546 LG Jisp, The Netherlands.
authors.forename: Marja H
authors.initials: MH
authors.lastname: Pronk
keywords: Clostridium difficile infection; Cost-effectiveness; Decision making; Guidance; Model; Standardisation