Background Severe sepsis is a leading cause of mortality in intensive care units (ICUs). Efficient and cost effective use of antibiotics is necessary for improving treatment outcomes.
Purpose The aim was to investigate cost utility and cost effectiveness of carbapenems versus piperacillin/tazobactam, as they are commonly used in the treatment of sepsis in our ICU.
Material and methods The study was conducted from August 2014 to May 2015 in the ICU of a tertiary university hospital. The cost effectiveness and cost utility analysis included all adult critically ill patients with sepsis who had received either a carbapenem (n=56) or piperacillin/tazobactam (n=28). Results were expressed in life years gained (LYG) adjusted with estimated reduction of LYG in patients with sepsis (0.51). Quality adjusted life years (QALYs) were obtained by multiplying LYGs with the utility value for sepsis(0.69). The incremental cost effectiveness ratio (ICER) was calculated as the ratio of the differences between LYGs and cost of treatment of both groups. The incremental cost utility ratio (ICUR) was the ratio of the difference between QALYs and cost of treatment. The confidence interval was obtained using Bootstrap resampling (2000 replications). The Mann–Whitney U test was used for statistical analysis between groups.
Results There were no differences between patients regarding age, gender and length of stay in the ICU. Patients in the carbapenem group had a tendency for a higher survival rate (48%) in comparison with the non-carbapenem group (39%), but this did not reach statistical significance. Costs were higher in the carbapenem group compared with patients treated with piperacillin/tazobactam (€752 per patient compared with €399 per patient; p<0.001). The ICER was €105 per LYG and the ICUR was €66 per QALY for carbapenem.
Conclusion The results showed that the use of carbapenems was associated with higher efficacy and costs. The low values for ICER and ICUR indicate that carbapenem is cost effective in patients with sepsis.
References and/or acknowledgements Sogayar AMC, Machado FR, Rea-Neto A, et al. A multicentre, prospective study to evaluate costs of septic patients in Brazilian intensive care units. Pharmacoeconomics2008;26:425–34.
No conflict of interest
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