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评估将一种新型抗菌药物引入希腊临床实践以治疗治疗选择有限的医院获得性感染的临床和经济影响。

Estimating the Clinical and Economic Impact of Introducing a New Antibacterial into Greek Clinical Practice for the Management of Hospital-Acquired Infections with Limited Treatment Options.

作者信息

Barmpouni Myrto, Gordon Jason P, Miller Ryan L, Pritchard Clive R J, Dennis James W, Grammelis Vassilis, Rousakis Aris, Souliotis Kyriakos, Poulakou Garyphallia, Daikos George L, Al-Taie Amer

机构信息

Pfizer Hellas, Athens, Greece.

Health Economics and Outcomes Research Ltd., Cardiff, UK.

出版信息

Infect Dis Ther. 2023 Feb;12(2):527-543. doi: 10.1007/s40121-022-00743-4. Epub 2022 Dec 21.

Abstract

INTRODUCTION

Hospital-acquired infections (HAIs) and growing antimicrobial resistance (AMR) represent a significant healthcare burden globally. Especially in Greece, HAIs with limited treatment options (LTO) pose a serious threat due to increased morbidity and mortality. This study aimed to estimate the clinical and economic value of introducing a new antibacterial for HAIs with LTO in Greece.

METHODS

A previously published and validated dynamic model of AMR was adapted to the Greek setting. The model estimated the clinical and economic outcomes of introducing a new antibacterial for the treatment of HAIs with LTO in Greece. The current treatment pathway was compared with introducing a new antibacterial to the treatment sequence. Outcomes were assessed from a third-party payer perspective, over a 10-year transmission period, with quality-adjusted life years (QALYs) and life years (LYs) gained considered over a lifetime horizon.

RESULTS

Over the next 10 years, HAIs with LTO in Greece account for approximately 1.4 million hospital bed days, hospitalisation costs of more than €320 million and a loss of approximately 403,000 LYs (319,000 QALYs). Introduction of the new antibacterial as first-line treatment provided the largest clinical and economic benefit, with savings of up to 93,000 bed days, approximately €21 million in hospitalisation costs and an additional 286,000 LYs (226,000 QALYs) in comparison to the current treatment strategy. The introduction of a new antibacterial was linked to a monetary benefit of €6.8 billion at a willingness to pay threshold of €30,000 over 10 years.

CONCLUSION

This study highlights the considerable clinical and economic benefit of introducing a new antibacterial for HAIs with LTO in Greece. This analysis shows the additional benefit when a new antibacterial is introduced to treatment sequences. These findings can be used to inform decision makers to implement policies to ensure timely access to new antibacterial treatments in Greece.

摘要

引言

医院获得性感染(HAIs)和日益增长的抗菌药物耐药性(AMR)在全球范围内构成了重大的医疗负担。特别是在希腊,由于发病率和死亡率上升,治疗选择有限(LTO)的医院获得性感染构成了严重威胁。本研究旨在评估在希腊引入一种用于治疗LTO医院获得性感染的新型抗菌药物的临床和经济价值。

方法

一个先前发表并经过验证的AMR动态模型被应用于希腊的情况。该模型估计了在希腊引入一种新型抗菌药物治疗LTO医院获得性感染的临床和经济结果。将当前的治疗途径与在治疗序列中引入新型抗菌药物进行了比较。从第三方支付者的角度,在10年的传播期内评估结果,同时考虑在整个生命周期内获得的质量调整生命年(QALYs)和生命年(LYs)。

结果

在未来10年中,希腊LTO医院获得性感染导致约140万住院日、超过3.2亿欧元的住院费用以及约40.3万生命年(31.9万QALYs)的损失。将新型抗菌药物作为一线治疗引入可带来最大的临床和经济效益,与当前治疗策略相比,可节省多达9.3万个住院日、约2100万欧元的住院费用以及额外的28.6万生命年(22.6万QALYs)。在10年中,以3万欧元的支付意愿阈值计算,引入新型抗菌药物带来了68亿欧元的货币收益。

结论

本研究突出了在希腊引入一种用于LTO医院获得性感染的新型抗菌药物所带来的巨大临床和经济效益。该分析显示了在治疗序列中引入新型抗菌药物时的额外益处。这些发现可用于为决策者提供信息,以实施政策确保在希腊及时获得新型抗菌药物治疗。

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