Costo-efectividad de linezolid comparado con vancomicina en el manejo de la neumonía asociada a ventilación mecánica en Colombia

Varón, Fabio Andrés; Londoño, Darı́o; Taborda, Alejandra; Prieto, Víctor Holguin

doi:10.1016/j.infect.2014.09.002

Cited by 3 publications

(4 citation statements)

References 25 publications

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“…In studies focusing on nosocomial pneumonia,25 26 36–43 linezolid showed a dominant ICER or ICER ranging from $5726 to $84 823 per death averted or life saved, and between $3179 and $21 488 per cure or treatment success among MRSA-infected patients, compared with vancomycin (online supplemental table SM6, section I). Variations in LOS and its associated economic costs across study settings accounted for differences in ICER.…”

Section: Resultsmentioning

confidence: 99%

Costs-effectiveness and cost components of pharmaceutical and non-pharmaceutical interventions affecting antibiotic resistance outcomes in hospital patients: a systematic literature review

Allel,

Hernández-Leal,

Naylor

et al. 2024

BMJ Glob Health

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IntroductionLimited information on costs and the cost-effectiveness of hospital interventions to reduce antibiotic resistance (ABR) hinder efficient resource allocation.MethodsWe conducted a systematic literature review for studies evaluating the costs and cost-effectiveness of pharmaceutical and non-pharmaceutical interventions aimed at reducing, monitoring and controlling ABR in patients. Articles published until 12 December 2023 were explored using EconLit, EMBASE and PubMed. We focused on critical or high-priority bacteria, as defined by the WHO, and intervention costs and incremental cost-effectiveness ratio (ICER). Following Preferred Reporting Items for Systematic review and Meta-Analysis guidelines, we extracted unit costs, ICERs and essential study information including country, intervention, bacteria-drug combination, discount rates, type of model and outcomes. Costs were reported in 2022 US dollars ($), adopting the healthcare system perspective. Country willingness-to-pay (WTP) thresholds from Woodset al2016 guided cost-effectiveness assessments. We assessed the studies reporting checklist using Drummond’s method.ResultsAmong 20 958 articles, 59 (32 pharmaceutical and 27 non-pharmaceutical interventions) met the inclusion criteria. Non-pharmaceutical interventions, such as hygiene measures, had unit costs as low as $1 per patient, contrasting with generally higher pharmaceutical intervention costs. Several studies found that linezolid-based treatments for methicillin-resistantStaphylococcus aureuswere cost-effective compared with vancomycin (ICER up to $21 488 per treatment success, all 16 studies’ ICERs<WTP). Infection control measures such as hand hygiene and gown usage (ICER=$1160/QALY or $4949 per ABR case averted, all ICERs<WTP) and PCR or chromogenic agar screening for ABR detection were highly cost-effective (eg, ICER=$1206 and $1115 per life-year saved in Europe and the USA). Comparisons were hindered by within-study differences.ConclusionRobust information on ABR interventions is critical for efficient resource allocation. We highlight cost-effective strategies for mitigating ABR in hospitals, emphasising substantial knowledge gaps, especially in low-income and middle-income countries. Our study serves as a resource for guiding future cost-effectiveness study design and analyses.PROSPERO registration numberCRD42020341827 and CRD42022340064

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Section: Resultsmentioning

confidence: 99%

Costs-effectiveness and cost components of pharmaceutical and non-pharmaceutical interventions affecting antibiotic resistance outcomes in hospital patients: a systematic literature review

Allel,

Hernández-Leal,

Naylor

et al. 2024

BMJ Glob Health

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“…A previous study conducted in Colombia, based on data from a singular randomized clinical trial, showcased that the total costs associated with a patient's cure were lower for LNZ compared to VMC. The cost-effectiveness ratio of linezolid relative to vancomycin was determined to be approximately US$1332 [ 11 ]. In this sense the strength of this study lies in the fact that it was based primarily on in the results of metanalysis of seven randomized clinical trials which constitutes the most recent evidence and with the highest level of evidence available regarding the effectiveness of LNZ compared to VMC.…”

Section: Discussionmentioning

confidence: 99%

“…The cost data used in this study were obtained from a previously published cost-disease study on VAP conducted in Colombia [ 11 ], Table 1 . Table 1 of the study provided detailed information on the costs.…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of linezolid to ventilator-associated pneumonia in Colombia

Buendía,

Patiño,

Zuluaga Salazar

2024

BMC Infect Dis

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Introduction Ventilator-associated pneumonia (VAP) is a prominent cause of morbidity and mortality in intensive care unit (ICU) patients. Due to the increase in Methicillin resistant Staphylococcus aureus infection, it is important to consider other more effective and safer alternatives compared to vancomycin. This motivates evaluating whether the use of an apparently more expensive drug such as linezolid can be cost-effective in Colombia. Methods A decision tree was used to simulate the results in terms of the cost and proportion of cured patients. In the simulation, patients can receive antibiotic treatment with linezolid (LZD 600 mg IV/12 h) or vancomycin (VCM 15 mg/kg iv/12 h) for 7 days, patients they can experience events adverse (renal failure and thrombocytopenia). The model was analyzed probabilistically, and a value of information analysis was conducted to inform the value of conducting further research to reduce current uncertainties in the evidence base. Cost-effectiveness was evaluated at a willingness-to-pay (WTP) value of US$5180. Results The mean incremental cost of LZD versus VCM is US$-517. This suggests that LZD is less costly. The proportion of patients cured when treated with LZD compared with VCM is 53 vs. 43%, respectively. The mean incremental benefit of LZD versus VCM is 10 This position of absolute dominance (LZD has lower costs and higher proportion of clinical cure than no supplementation) is unnecessary to estimate the incremental cost-effectiveness ratio. There is uncertainty with a 0.999 probability that LZD is more cost-effective than VCM. Our base‐case results were robust to variations in all assumptions and parameters. Conclusion LNZ is a cost-effective strategy for patients, ≥ 18 years of age, with VAP in Colombia- Our study provides evidence that can be used by decision-makers to improve clinical practice guidelines.

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“…Cabe resaltar que Y > X si el esquema por evaluar es más costoso que su contraparte. A mayores umbrales, el esquema que representa costos más altos va a ser costo-efectivo en un porcentaje mayor de las iteraciones realizadas (15).…”

Section: Análisis De Sensibilidadunclassified

Metodología del análisis de costo-efectividad (ACE) en la práctica clínica

Amaya

Romero

2015

Investig. segur. soc. salud.

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Objetivo: Ilustrar la metodología detrás del análisis de costo-efectividad en la práctica clínica actual. Métodos: Revisión narrativa de algunos de los principales aportes en esta área. Desarrollo: La primera parte se encarga de explicar la importancia que tienen las evaluaciones económicas (en especial, el análisis de costo-efectividad) para los sistemas de salud en el mundo y los hacedores de política pública. En la segunda parte, el artículo desglosa cada aspecto de la metodología para otorgar herramientas suficientes a la hora de construir una evaluación de este tipo. Se ofrecen diagramas de herramientas conocidas como los árboles de decisión y el modelo de Markov, para entender a fondo los resultados y poder interpretarlos de manera correcta. Se exponen las ventajas y las limitaciones de la evaluación de costo-efectividad. Conclusión: Se proveen las bases del análisis de costo-efectividad para soportar los estudios de este tipo.

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Costo-efectividad de linezolid comparado con vancomicina en el manejo de la neumonía asociada a ventilación mecánica en Colombia

Cited by 3 publications

References 25 publications

Costs-effectiveness and cost components of pharmaceutical and non-pharmaceutical interventions affecting antibiotic resistance outcomes in hospital patients: a systematic literature review

Costs-effectiveness and cost components of pharmaceutical and non-pharmaceutical interventions affecting antibiotic resistance outcomes in hospital patients: a systematic literature review

Cost-effectiveness of linezolid to ventilator-associated pneumonia in Colombia

Metodología del análisis de costo-efectividad (ACE) en la práctica clínica

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