A BUDGET IMPACT ANALYSIS OF FIDAXOMICIN VERSUS VANCOMYCIN AND METRONIDAZOLE FOR THE TREATMENT OF CLOSTRIDIUM DIFFICILE
Author(s)
Leinwand B
Avalere Health LLC, Washington, DC, USA
OBJECTIVES: To estimate the health outcomes and financial impact to a private healthcare payer of treatments for mild/moderate and severe clostridium difficile infection (CDI) acquired from the hospital or community setting METHODS: We developed a budget impact model from the U.S. payer perspective, which followed patients over a 6-month time horizon beginning with an initial CDI episode for up to two additional recurrent episodes. In severe CDI episodes, we model two index inpatient treatments – vancomycin and fidaxomicin; however, for mild/moderate cases, we added metronidazole to the treatment choices. The model explicitly incorporates drugs costs, hospital costs attributable to CDI, and costs associated with outpatient follow-up or prescription medications acquired in the community setting. Clinical outcomes are measured as the number/rates of clinical cures and recurrences. RESULTS: The base case model assumed a hypothetical private health plan with one million covered lives, 75% of which are below the age of 65, and indicated that use of fidaxomicin led to a lower incidence of CDI recurrence, with 174 fewer first recurrences and 66 fewer second recurrences. Total plan costs for the treatment of CDI were just under $34 million before introduction of fidaxomicin, and just under $33 million after its introduction, a savings of 3.16%. Total savings per-member per-month were $0.09. We conducted a series of one-way sensitivity analyses to test the impact of key assumptions on plan savings after introduction of fidaxomicin, and while the magnitude of cost savings varied, directionality remained consistent, indicating improved effectiveness and economic efficiency upon introduction of fidaxomicin. CONCLUSIONS: The results of this model demonstrate that fidaxomicin is superior to other treatments in preventing CDI recurrence, and through reductions in recurrence, payers can expect moderate cost savings over a 6-month time horizon
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PGI7
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Gastrointestinal Disorders, Infectious Disease (non-vaccine)