OBJECTIVES: Аntibiotic resistance, and in particular emerging resistance in Gram-negative bacteria, is one of the most significant health problems faced by the world today, limiting treatment options to just a few antibiotics. The primary objective of this study was to evaluate the budget impact (BI) of the implementation of ceftazidime/avibactam (CAZ-AVI) as a treatment of adult patients with complicated urinary tract infection (cUTI), including pyelonephritis in Bulgaria.

METHODS: A BI model was built in Excel to evaluate the economic impact of CAZ-AVI for the treatment of cUTI in Bulgaria. For the base case analysis, the model was developed and populated with epidemiologic local data and compared the total budgetary costs of a scenario with CAZ-AVI versus a scenario without CAZ-AVI. Costs were calculated according to the Positive Drug List (PDL) as of July 2018. The base case time horizon in the model was 5 years.

RESULTS: The BI analysis estimated that after the inclusion of CAZ-AVI in the reimbursement list the added cost would be 108 794 BGN in year 1 and would reach 269 458 BGN in year 5. The total added expenditure for the whole analysed five-year period amounted to 892 815 BGN.

CONCLUSIONS: Although the new technology adds costs to the payer (hospital), CAZ-AVI specifications make it a good choice of antibiotic therapy, especially in patients with difficult to treat infections where the pathogen is likely to carry resistance mutations.