Potential Cost Savings Associated with Targeted Substitution of Current Guideline-Concordant Inpatient Agents with Omadacycline for the Treatment of Adult Hospitalized Patients with Community-Acquired Bacterial Pneumonia at High Risk for Clostridioides difficile Infections: Results of Healthcare-Decision Analytic Model from the United States Hospital Perspective.
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Issue Date
2021-10
Authors
Lodise, Thomas P
Rodriguez, Mauricio
Chitra, Surya
Wright, Kelly
Patel, Nimish
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Abstract
INTRODUCTION: Approximately 3% of hospitalized patients with community-acquired bacterial pneumonia (CABP) develop healthcare-associated Clostridioides difficile infection (HCA-CDI). The validated Davis risk score (DRS) indicates that patients with a DRS >/= 6 are at an increased risk of 30-day HCA-CDI. In the phase 3 OPTIC CABP study, 14% of CABP patients with DRS >/= 6 who received moxifloxacin developed CDI vs. 0% for omadacycline. This study assessed the potential economic impact of substituting current guideline-concordant CABP inpatient treatments with omadacycline in hospitalized CABP patients with a DRS >/= 6 across US hospitals. METHODS: A deterministic healthcare-decision analytic model was developed. The model population was hospitalized adult CABP patients with a DRS >/= 6 across US hospitals (100,000 patients). In the guideline-concordant arm, 14% of CABP patients with DRS >/= 6 were assumed to develop an HCA-CDI, each costing USD 20,100. In the omadacycline arm, 5 days of therapy was calculated for the entire model population. RESULTS: The use of omadacycline in place of guideline-concordant CABP inpatient treatments for CABP patients with DRS >/= 6 was estimated to result in cost savings of USD 55.4 million annually across US hospitals. CONCLUSION: The findings of this simulated model suggest that prioritizing the use of omadacycline over current CABP treatments in hospitalized CABP with a DRS >/= 6 may potentially reduce attributable HCA-CDI costs. The findings are not unique to omadacycline and could be applied to any antibiotic that confers a lower risk of HCA-CDI relative to current CABP inpatient treatments.
Citation
Lodise T, Rodriguez M, Chitra S, Wright K, Patel N. Potential Cost Savings Associated with Targeted Substitution of Current Guideline-Concordant Inpatient Agents with Omadacycline for the Treatment of Adult Hospitalized Patients with Community-Acquired Bacterial Pneumonia at High Risk for Clostridioides difficile Infections: Results of Healthcare-Decision Analytic Model from the United States Hospital Perspective. Antibiotics (Basel). 2021 Oct 1;10(10):1195. doi: 10.3390/antibiotics10101195. PMID: 34680776; PMCID: PMC8532985.