PIN41 - Cost-Effectiveness Evaluation of Ertapenem in the Treatment of Adult Patients with Community-Acquired Complicated Intraabdominal Infection

Abstract

To evaluate the cost-effectiveness of ertapenem versus piperaciliin/tazobactam and ceftriaxone/metronidazole in the treatment of patients with community-acquired complicated intraabdominal infections (IAI) in Colombia. For the cost-effectiveness analysis a previous published model that simulates the natural history of the disease, was adapted to Colombia setting. A systematic review of literature was done to extract the clinical data of safety and effectiveness for ertapenem in the prevention of complications and other health outcomes associated with IAI. The susceptibility profile of the different pathogens was described from Colombia SMART data, and clinical efficacy was adjusted by the distribution of pathogens in Colombia. Cost data were obtained from a database of a Colombian insurer and official lists for drugs prices. The economic evaluation was performed under the third payer perspective. A probabilistic sensitivity analysis was done using a Montecarlo simulation with 1,000 iterations, furthermore, an univariate sensitivity analysis was estimated by a tornado diagram. The effectiveness obtained after the adjustment (proportion of IAI cases successfully treated) was 89% for ertapenem, 73.6% for piperacilin/tazobactam, and 86% for ceftriaxone/metronidazole. In the cost-effectiveness evaluation, the cost generated to treat of a patient with IAI with ertapenem was COP $9,310,566 while with piperacilin/tazobactam was of COP $10,085,603 and with ceftriaxone/metronidazol COP$ $9,444,063. It is estimated that gaining 15.7% and 3.4% additional effectiveness units (clinical success case) costs COP$775,037 and COP$133,497 less with ertapenem, compared to piperacilin/tazobactam y ceftriaxone/metronidazole, repectively. In Colombia, IAI treatment with ertapenem is cost saving when compared with piperaciclin/tazobactam and ceftriaxone/metronidazole.