Cost-Effectiveness of Minocycline Intravenous for the Treatment of Serious Infections Due to Multidrug-Resistant Acinetobacter baumannii in Jordan
Author(s)
Faris Bakri, MD,PhD1, Maria T. Al-Zoubi, B.Pharm2, Rihab Al-Homsi, Pharm.D2, Ahmad N. Aburmilah, M.Sc2.
1Infectious Diseases, The University of Jordan, Amman, Jordan, 2Hikma pharmaceuticals, Amman, Jordan.
1Infectious Diseases, The University of Jordan, Amman, Jordan, 2Hikma pharmaceuticals, Amman, Jordan.
OBJECTIVES: Acinetobacter baumannii is one of the most critical multidrug-resistant (MDR) pathogens in healthcare settings globally, with rising resistance to commonly used antibiotics. Intravenous (IV) minocycline has demonstrated clinical efficacy and favorable safety profile for the treatment of infections caused by MDR A. baumannii. This study assesses the cost-effectiveness of IV minocycline versus IV colistin in treating MDR A. baumannii infections in Jordan.
METHODS: A 28-day decision-tree model was developed to evaluate the cost-effectiveness of IV minocycline compared to IV colistin for the treatment of MDR Acinetobacter baumannii infections from a Jordanian payer perspective. Direct medical costs included drug acquisition, IV administration, hospitalization, medical consultation, nephrotoxicity management and acute renal failure (ARF) requiring dialysis. Drug prices were sourced from Jordanian Food and Drug Administration. Local resource utilization costs were estimated from four private hospitals in Amman, Jordan. The model incorporated the rates of cure, mortality, nephrotoxicity and ARF requiring dialysis for both treatment arms, dose adjustment in case of acute renal failure and treatment regimen modification in case of initial therapy failure. All data were derived from clinical guidelines and published studies. Health utilities were retrieved from literature. Deterministic sensitivity analysis (DSA) was conducted.
RESULTS: Total treatment costs were 3,316.34 Jordanian Dinar (JOD) for minocycline and 4,827.98 JOD for colistin. Estimated QALYs were 0.2148 for minocycline and 0.1523 for colistin. The incremental cost-effectiveness ratio (ICER) for minocycline versus colistin was -24,159.70 JOD per QALY gained, indicating a dominant strategy. DSA demonstrated that the results were robust to changes in input parameters. The model was most sensitive to changes in mortality rates associated with both treatments.
CONCLUSIONS: IV minocycline is a dominant treatment option for MDR A. baumannii infections in Jordan. These findings may support clinicians and healthcare decision-makers in prescribing cost-effective therapies, contributing to more efficient allocation of healthcare resources.
METHODS: A 28-day decision-tree model was developed to evaluate the cost-effectiveness of IV minocycline compared to IV colistin for the treatment of MDR Acinetobacter baumannii infections from a Jordanian payer perspective. Direct medical costs included drug acquisition, IV administration, hospitalization, medical consultation, nephrotoxicity management and acute renal failure (ARF) requiring dialysis. Drug prices were sourced from Jordanian Food and Drug Administration. Local resource utilization costs were estimated from four private hospitals in Amman, Jordan. The model incorporated the rates of cure, mortality, nephrotoxicity and ARF requiring dialysis for both treatment arms, dose adjustment in case of acute renal failure and treatment regimen modification in case of initial therapy failure. All data were derived from clinical guidelines and published studies. Health utilities were retrieved from literature. Deterministic sensitivity analysis (DSA) was conducted.
RESULTS: Total treatment costs were 3,316.34 Jordanian Dinar (JOD) for minocycline and 4,827.98 JOD for colistin. Estimated QALYs were 0.2148 for minocycline and 0.1523 for colistin. The incremental cost-effectiveness ratio (ICER) for minocycline versus colistin was -24,159.70 JOD per QALY gained, indicating a dominant strategy. DSA demonstrated that the results were robust to changes in input parameters. The model was most sensitive to changes in mortality rates associated with both treatments.
CONCLUSIONS: IV minocycline is a dominant treatment option for MDR A. baumannii infections in Jordan. These findings may support clinicians and healthcare decision-makers in prescribing cost-effective therapies, contributing to more efficient allocation of healthcare resources.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE259
Topic
Economic Evaluation
Disease
Infectious Disease (non-vaccine)