Objectives: C. difficile is the leading cause of antibiotic associated infectious nosocomial diarrhoea. The two main treatments for these patients are fidaxomicin and vancomycin. In two phase III randomized controlled trials fidaxomicin was found to be non inferior to vancomycin in initial clinical cure of CDI and superior in preventing recurrences. The main goal of this economic analysis was to evaluate the cost-effectiveness of fidaxomicin versus vancomycin, for the treatment of C. difficile infection in Hungary. Methods: A decision tree model was developed to capture the consequences of recurrent infections with both treatment options. The model reported two clinical outcomes: clinical cure and recurrent CDI episodes. Treatment efficacy was estimated through a meta-analysis in a Bayesian framework. The model took the third party payer perspective. The incremental cost-effectiveness ratio was calculated as the ratio between costs and number of avoided recurrent episodes. Uncertainty around model parameters was assessed through probabilistic sensitivity analysis. Results: Total average costs for fidaxomicin and vancomycin therapies were 3,987 and 2,505 per patient, respectively. The average number of recurrent episodes per patients was lower with fidaxomicin therapy (0.13 recurrent episodes/patient) than with vancomycin therapy (0.40 recurrent episodes/patient). Incremental cost-effectiveness ratio (fidaxomicin vs. vancomycin) was 5,520 per avoided recurrent episode. Conclusions: In conclusion, this study found that fidaxomicin has favourable cost-effectiveness ratio compared to vancomycin.
Brodszky, V., Strbák, B., Baji, P., Péntek, M., & Gulacsi, L. (2014). Cost-Effectiveness of Fidaxomicin Therapy for Clostridium Difficile Infection in Hungary. Value in Health, 17(7), A675. https://doi.org/10.1016/j.jval.2014.08.2505