OBJECTIVES : Antimicrobial resistance is a major public health threat in Singapore. Access to quality medicine is critical to address risk of antimicrobial resistance. CAZ-AVI was developed for treatment of a broad range of gram-negative bacterial infections. This study aimed to find budget impact from the perspective of Singapore healthcare with CAZ-AVI and currently available antibiotics in the treatment of complicated intra-abdominal (cIAI), complicated urinary tract (cUTI), hospital-acquired pneumonia (HAP) and aerobic Gram-negative infections with limited treatment options (Infections w/ LTO)

METHODS : A budget Impact Model was developed with 3-year-time horizon. Cost data were from Singapore statistics, public surveillance and literature reviews. Costs were estimated based on prevalence of diseases, type of medication, period of treatment, length of hospital stay, rate of adverse event, market competition and monitoring costs. Based on the assumption of CAZ-AVI introduction, overall budget was calculated by estimating costs of treatment options of cIAI, cUTI, HAP and Infections with LTO reflecting proportion of patients for 3 years comparing with current available options.

RESULTS : Total eligible population for 3 years was estimated around 22,000 and 3-year-total costs including CAZ-AVI were around 340 million SGD. When CAZ-AVI included as a new treatment, 1.5% or 240 SGD per patient was increased for 3 years. Due to drug cost of CAZ-AVI, treatment costs of 6 million SGD (17%) were increased. Hospital stay were decreased from around 349,000 days with current available options to around 348,000 days when CAZ-AVI was included. Impact of CAZ-AVI inclusion for 3 years by cIAI, cUTI, HAP and Infections with LTO are 138 SGD (1%), 115 SGD (1%), 205 SGD (1%), 827 SGD (3.5%), respectively.

CONCLUSIONS : Impact on new options of CAZ-AVI in the treatment of cIAI, cUTI, HAP and infections with LTO can be marginal on the total Singapore healthcare budget.