English, Article edition: Cost Effectiveness of Cephalosporin Monotherapy and Aminoglycoside/ Ureidopenicillin Combination Therapy: For the Treatment of Febrile Episodes in Neutropenic Patients Joseph A. Paladino; Debra A. Fong; Alan Forrest; ...

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Physical Description
  • article
Language
  • English

Edition details

Title
  • Cost Effectiveness of Cephalosporin Monotherapy and Aminoglycoside/​ Ureidopenicillin Combination Therapy: For the Treatment of Febrile Episodes in Neutropenic Patients
Author
  • Joseph A. Paladino
  • Debra A. Fong
  • Alan Forrest
  • Reuben Ramphal
Physical Description
  • article
Notes
  • Objective: To assess the relative cost effectiveness of cephalosporin monotherapy options and aminoglycoside/​ureidopenicillin combination therapy for the treatment of febrile episodes in adult patients with neutropenia. Design and setting: This was a retrospective cost-effectiveness analysis conducted from the institutional perspective. Methods: The analysis was based on 741 febrile episodes in adult patients with neutropenia enrolled in 5 randomised trials: 3 comparing monotherapy with ceftazidime or cefepime, and 2 comparing cefepime monotherapy versus aminoglycoside/​ureidopenicillin combination therapy. Resource utilisation included costs for study antibacterials, treatment of adverse effects and failures, and hospitalisation. The primary end-point was the overall cost of treatment per patient. Cost-effectiveness ratios were also analysed. Results: No significant differences in clinical success rates were detected. Median per-patient costs in the monotherapy comparisons were $US7849 for cefepime and $US7788 for ceftazidime [1997 values; not significantly different (NS)]. Corresponding costs for the monotherapy versus combination therapy comparisons were $US9780 for cefepime and $US10 159 for gentamicin/​ureidopenicillin (NS). Despite a higher acquisition cost for cefepime, there were no statistically significant differences in cost effectiveness compared with either ceftazidime monotherapy or gentamicin/​ureidopenicillin combination therapy. Sensitivity analyses revealed that monotherapy can be cost effective compared with combination therapy in many situations. Conclusion: There were no economic differences between the 3 regimens tested. Therefore, drug cost should not be a deciding factor when choosing antibacterial therapy for the treatment of febrile episodes in adult patients with neutropenia.
  • Aminoglycosides, Antibacterials, Cefalosporins, Cefepime, Ceftazidime, Cost analysis, Fever, Gentamicin, Immunocompromised infections, Penicillins, Pharmacoeconomics
  • RePEc:wkh:phecon:v:18:y:2000:i:4:p:369-381
Language
  • English
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