COST-EFFECTIVENESS ANALYSIS OF IMIPENEM/CILASTATIN/RELEBACTAM FOR CARBAPENEM-NON-SUSCEPTIBLE GRAM-NEGATIVE BACTERIAL INFECTIONS IN CHINA
Author(s)
jingwei si, Master Candidate1, Yvyang Zhang, Master Candidate2, Yiling Jiang, MSc3, Xiaomin Duan, Master4, Shitong Xie, PhD2.
1student, Tianjin University, Tianjin, China, 2Tianjin University, Tianjin, China, 3Merck Sharp & Dohme (UK) Limited, London, United Kingdom, 4MSD, Shanghai, China.
1student, Tianjin University, Tianjin, China, 2Tianjin University, Tianjin, China, 3Merck Sharp & Dohme (UK) Limited, London, United Kingdom, 4MSD, Shanghai, China.
OBJECTIVES: To evaluate the cost-effectiveness of imipenem/cilastatin/relebactam (IMI/REL) compared with colistin plus imipenem/cilastatin (CMS+IMI) for the treatment of hospitalized adult patients with hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia, complicated intra-abdominal infections, or complicated urinary tract infections caused by carbapenem-non-susceptible Gram-negative bacteria in China.
METHODS: A cost-utility analysis was conducted from the perspective of the Chinese healthcare system, using a decision tree combined with a three-state Markov model (cured, uncured, death) to simulate lifetime outcomes. Short-term clinical transition parameters were primarily derived from the international multicenter phase III clinical trial RESTORE-IMI 1. Cost (including treatment cost, resource use cost, AE cost, monitoring cost) and utility parameters were mainly sourced from Pharnexcloud's provincial tender prices, published literature, and clinical expert input. The primary outcome was the incremental cost-effectiveness ratio (ICER), with China's 2024 per capita GDP (CNY 95,749 per QALY) used as the willingness-to-pay (WTP) threshold. One-way and probabilistic sensitivity analyses, along with scenario analyses, were performed to test the robustness of the results.
RESULTS: The base-case analysis showed that, compared to CMS+IMI, IMI/REL (CNY 1,240 per 1.25g) incurred an incremental cost of CNY 34,765 per patient while yielding an incremental gain of 3.12 QALYs per patient. The resulting ICER was CNY 11,149 per QALY, substantially below the WTP threshold. Economic advantage was primarily attributed to IMI/REL reducing CNY 4,809 in direct medical resource costs and CNY 1,233 in adverse event management. Probabilistic sensitivity analysis indicated a 96.4% probability of IMI/REL being cost-effective at the WTP threshold. Extensive scenario analyses and one-way sensitivity analyses confirmed the robustness of findings.
CONCLUSIONS: At a WTP threshold of per capita GDP, IMI/REL is a cost-effective option compared to CMS+IMI for adult patients in China with hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia, complicated intra-abdominal infections, or complicated urinary tract infections caused by carbapenem-non-susceptible Gram-negative bacteria.
METHODS: A cost-utility analysis was conducted from the perspective of the Chinese healthcare system, using a decision tree combined with a three-state Markov model (cured, uncured, death) to simulate lifetime outcomes. Short-term clinical transition parameters were primarily derived from the international multicenter phase III clinical trial RESTORE-IMI 1. Cost (including treatment cost, resource use cost, AE cost, monitoring cost) and utility parameters were mainly sourced from Pharnexcloud's provincial tender prices, published literature, and clinical expert input. The primary outcome was the incremental cost-effectiveness ratio (ICER), with China's 2024 per capita GDP (CNY 95,749 per QALY) used as the willingness-to-pay (WTP) threshold. One-way and probabilistic sensitivity analyses, along with scenario analyses, were performed to test the robustness of the results.
RESULTS: The base-case analysis showed that, compared to CMS+IMI, IMI/REL (CNY 1,240 per 1.25g) incurred an incremental cost of CNY 34,765 per patient while yielding an incremental gain of 3.12 QALYs per patient. The resulting ICER was CNY 11,149 per QALY, substantially below the WTP threshold. Economic advantage was primarily attributed to IMI/REL reducing CNY 4,809 in direct medical resource costs and CNY 1,233 in adverse event management. Probabilistic sensitivity analysis indicated a 96.4% probability of IMI/REL being cost-effective at the WTP threshold. Extensive scenario analyses and one-way sensitivity analyses confirmed the robustness of findings.
CONCLUSIONS: At a WTP threshold of per capita GDP, IMI/REL is a cost-effective option compared to CMS+IMI for adult patients in China with hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia, complicated intra-abdominal infections, or complicated urinary tract infections caused by carbapenem-non-susceptible Gram-negative bacteria.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE335
Topic
Economic Evaluation
Disease
SDC: Infectious Disease (non-vaccine), SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), SDC: Urinary/Kidney Disorders