Objectives: Clostridium difficile infection (CDI) is associated with considerable morbidity, mortality and healthcare resource utilisation. This research aims to model and evaluate the cost-effectiveness of bezlotoxumab, a new antitoxin agent + standard of care (SOC) compared with placebo + SoC patients with recurrent CDI (rCDI) in the U.K. Methods: We developed a computer-based Markov health state transition model to simulate the natural history of CDI. Patients with CDI were followed from infection until death. Costs and effectiveness were evaluated using a third-party payer perspective. Recurrence rates were taken from point estimates taken from pooled data of the two phase 3 clinical trials. Transition probabilities and costs of rCDI were obtained from the literature. Cost-effectiveness analysis was conducted in three different patient populations: the entire clinical trial population, CDI patients at higher risk of rCDI-aged 65 years or above, and those with a prior history of rCDI within 6 months. Costs and benefits were discounted annually at 3.5% Results: The model predicted that treating patients with bezlotoxumab + SoC resulted in 0.1170, 0.1022, and 0.1628 incremental discounted QALYs gained per patient for the trial population, ≥ 65 years and those with a prior history, respectively. The increment discounted costs were £1,321.15, £630.38, and £670.58 in these three groups. Incremental cost-effectiveness ratios were estimated at £11,287.55, £6,170.30, and £4,117.84 per QALY gained for the trial population, ≥ 65 years and those with a prior history, respectively. Key influential parameters include CDI-specific mortality, cost of an rCDI episode, and underlying recurrence rate. ConClusions: Based on the Markov model, bezlotoxumab in combination with SoC has the potential to reduce the disease burden associated with CDI in a cost-effective manner, by reducing the incidence of rCDI.
Ahir, H., Jiang, Y., Marcella, S., & Tierney, P. (2017). Cost-Effectiveness Of Bezlotoxumab + Standard Of Care (SOC) Versus Placebo + Soc For The Prevention Of Recurrent Clostridium Difficile Infection In The United Kingdom. Value in Health, 20(9), A790. https://doi.org/10.1016/j.jval.2017.08.2319