| Summary: | 碩士 === 高雄醫學大學 === 醫務管理暨醫療資訊學系碩士在職專班 === 106 === Research Purposes
Fidaxomicin is a new class of Clostridium difficile infection (CDI) treatment agent, but the acquisition cost is markedly higher than that of the traditional treatment (oral vancomycin). This study was to investigate the cost-effectiveness analysis of the clinical effects and total medical costs of fidaxomicin and vancomycin used in CDI in Taiwan.
Material and Methods
In this study, we are using TreeAge pro software for the decision analysis of cost-effectiveness model of fidaxomicn compared to vancomycin for the treatment of CDI. The decision analysis model was used to determine of base- case clinical probability estimates, as well as analyze and interpret the results. The analysis was performed from a Taiwan’s national health insurance perspective.
Results
The total medical cost was NT$74,598 when fidaxomicin was used for the treatment of severe CDI, and the oral vancomycin group was NT$44,992. The unit cost of fidaxomicin was much higher than that of vancomycin, but there is no great difference in the total medical cost between fidaxomicin and vancomycin, as the disease relapse rate and associated hospital-related medical care costs were lower in fidaxomicin group. The clinical efficacy outcome in QALY of the fidaxomicin group is 6.46, and 6.39 for the vancomycin group. The incremental cost-effectiveness ratio (ICER) of fidaxomicin compared with oral vancomycin is NT$381,516.26/quality-adjusted life-year (QALY) gained. Using the willingness to pay (WTP) of NT$1,481,310 (estimated two times the national annual GDP per capita)/QALY gained, fidaxomicin is cost-effective when compared with oral vancomycin.
Conclusions and Suggestions
In hospitalized patients with severe clostridium difficile infections, fidaxomicin is cost-effective comparing with oral vancomycin. Since there is a lack of consensus on management strategies for clostridium difficile infections in Taiwan, for those hospitalized patients who meet the above conditions, the health insurance policy for fidaxomicin should consider referring to global treatment guidelines and promote it as a first-line medication option for severe patients.
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