Presentation (CTI)

OBJECTIVES: The emergence of antibiotic resistance has complicated treatment strategies for urinary tract infections (UTI). Sulopenem has demonstrated promise in treating uncomplicated urinary tract infections (UTIs) with comparable efficacy to Ciprofloxacin. This study aimed to assess the cost-effectiveness of Sulopenem compared to Ciprofloxacin for managing uncomplicated UTIs in women.
METHODS: A decision-analytic model was developed using data from the SURE-1 trial (NCT03354598), which compared the efficacy and safety of Sulopenem and Ciprofloxacin for treating uncomplicated UTIs. The analysis was conducted from the payers’ perspective using direct medical costs. The model incorporated cure status (complete or incomplete), adverse drug reactions (mild or severe), and 28-day all-cause mortality. Patients with incomplete clinical cure were assumed to require additional follow-up treatment with second-line antibiotics. The model used a 28-day time horizon, and all cost inputs were indexed to 2024 USD. QALYs were estimated by applying literature-based utility values to the health states represented in the model. We also conducted a two-way sensitivity analysis by varying both the cost and the utility values associated with Sulopenem.
RESULTS: The expected cost of treatment was $9,480.77 with Sulopenem and $629.38 with Ciprofloxacin. The quality-adjusted life years (QALYs) were 0.90 for Ciprofloxacin and 0.89 for Sulopenem. Ciprofloxacin was found to be the dominant therapy given its lower cost and slightly higher QALY. Results from a two-way sensitivity analysis suggest that Sulopenem would have to result in QALY values higher than 0.90 with a cost less than $2,000 to be considered cost-effective at a willingness to pay of $150,000.
CONCLUSIONS: Ciprofloxacin was found to be the cost-effective choice for treating uncomplicated UTIs in women under typical clinical scenarios.