Cost-Effectiveness Analysis Of Joint Vaccination With 13-Valent Pneumococcal Conjugate Vaccine (Pcv13) And Influenza Vaccine In Taiwan During Seasonal Influenza

Abstract

A273 from remission, progression to long-term adverse outcomes (cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, end-stage liver disease) and commonly observed side effects (anemia, neutropenia and rash) along with a gradient of their severity. Model inputs were determined from a review of the published literature and phase II or III clinical trials. Clinical trials estimates were converted to risk ratios to facilitate comparison. Costs were inflated to 2013 US dollars. Costs and quality adjusted life years were discounted at standard rate of 5%. Sensitivity analyses were performed to assess model sensitivity and address uncertainty. Results: Relative to treatment with PR only, response-guided triple therapy with BOC+PR was the most cost effective therapy (ICER $28,723/QALY) followed by responseguided triple therapy with TVR+PR (ICER $64,569/QALY). PR treatments with SIM or SOF were dominated by BOC+PR. The model was sensitive to variations in costs of initial drug therapy and likelihood of attaining SVR. ConClusions: Addition of protease inhibitors to PR therapy improves health outcomes. Response-guided regimen BOC+PR was found to be cost-effective for treating newly diagnosed genotype 1 HCV patients. Shortening of PR therapy guided by a rapid virologic response may help reduce overall costs. Robust sensitivity analyses can help in overcoming the challenge of sparse data availability.objeCtives: To compare Ertapenem with piperacillin/tazobactam (pip/tazo) for the treatment of moderate to severe community acquired intra-abdominal infections (c-IAI) in Colombia health care setting, with respect to cost and outcomes taking into account development of anti-microbial resistance (AMR). Methods: A previously published decision tree model was adapted to estimate cost-effectiveness of Ertapenem vs. pip/tazo. Clinical efficacy, adverse events and medical resource use were derived from literature. AMR to Ertapenem and pip/tazo was calculated as weighted average based on the % distribution of different pathogens in c-IAI in Colombia and the sensitivity of Erta vs. pip/tazo for each pathogen from Colombia SMART data. The resistance-adjusted effectiveness is then computed based on efficacy from clinical trial and local AMR data, Model outcomes included resistance, clinical success, deaths, life years, direct costs, and costs per successfully treated patient. Results: The overall resistance of Ertapenem vs. pip/tazo for c-IAI is 21.4% vs. 43.4%. The resistance-adjusted effectiveness are 70.3% vs. 46% for Ertapenem vs. pip/tazo. Daily drug costs are 133,550 (Ertapenem) vs. 34,989 (pip/tazo) Colombian Pesos. Total costs (including drug costs, hospitalization, cost of 2 nd -line treatment & cost of AEs) are 7,162,081 (Ertapenem) vs. 7,230,902 (pip/tazo) Pesos. During the first hospitalization period, Ertapenem is associated with a 24.3% higher treatment success rate, and a 68,821 Pesos in cost saving when compared with Pip/tazo. The Incremental cost per successfully treated patient (ICER) is -283,405 Colombian Pesos ...

Mathematical modeling of postcoinfection with influenza A virus and <em>Streptococcus pneumoniae</em>, with implications for pneumonia and COPD-risk assessment

“…Pneumococcal diseases and influenza have caused substantial clinical and economic burden in Taiwan, particularly in young children and people aged ≥65 years 35. Moreover, the Taiwan Centers for Disease Control has incorporated severely complicated influenza and invasive pneumococcus into their list of categories III and IV notifiable communicable diseases.…”

“… 34 Pneumococcal diseases and influenza have caused substantial clinical and economic burden in Taiwan, particularly in young children and people aged ≥65 years. 35 Moreover, the Taiwan Centers for Disease Control has incorporated severely complicated influenza and invasive pneumococcus into their list of categories III and IV notifiable communicable diseases. Continuous surveillance of respiratory illnesses and influenza antigen-detection tests are necessary to identify disease outbreaks so that infection-control measures can be promptly initiated in the inpatient and outpatient settings.…”