Fidaxomicin versus Vancomycin as a First-Line Treatment for Clostridium difficile-Associated Diarrhea (CDAD) in Specific Patient Populations: A Pharmacoeconomic Evaluation.
Pharmacotherapy. 2017 Oct 17;:
Authors: Reveles KR, Backo JL, Corvino FA, Zivkovic M, Broderick KC
Abstract
OBJECTIVES: The reduction in recurrent Clostridium difficile-associated diarrhea (CDAD) with fidaxomicin therapy may reduce hospital readmissions and lead to lower overall CDAD costs. However, studies assessing the cost-effectiveness of fidaxomicin as first-line therapy from the United States (US) hospital perspective are lacking. This study evaluated the costs associated with utilizing fidaxomicin or vancomycin as a first-line therapy for CDAD in specific patient populations from a US hospital perspective.
METHODS: A decision-analytic model was developed to estimate total costs (hospitalization and drug costs) associated with using fidaxomicin or vancomycin as first-line therapy for a first episode and up to 2 recurrences of CDAD in 5 patient populations: general population, elderly, patients receiving concomitant antibiotics, and patients with renal impairment or cancer.
RESULTS: The total cost of CDAD treatment using fidaxomicin first-line in the general population was $14,442 per patient versus $14,179 per patient with vancomycin first-line. In subgroup analyses, fidaxomicin use resulted in total hospital cost savings of $616 per patient in patients with cancer and $312 in patients with concomitant antibiotic use; vancomycin use was associated with total hospital cost savings of $243 per patient in the elderly and $371 in patients with renal impairment.
CONCLUSIONS: Fidaxomicin as first-line CDAD therapy is associated with similar total costs as compounded vancomycin oral solution in the general population. In elderly and renally-impaired patients, slight increases in hospital cost were observed with fidaxomicin therapy, while in patients with cancer or concomitant antibiotic use hospital cost savings were observed. This article is protected by copyright. All rights reserved.
PMID: 29044643 [PubMed - as supplied by publisher]