Title :

Cost-effectiveness analysis of five competing strategies for the management of multiple recurrent community-onset clostridium difficile infection in france

Author(s) :

Baro, Emilie [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Galperine, Tatiana [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Denies, Fanette [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lannoy, Damien [Auteur]
Groupe de Recherche sur les formes Injectables et les Technologies Associées - ULR 7365 [GRITA]
Lenne, Xavier [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Odou, Pascal [Auteur]
Groupe de Recherche sur les formes Injectables et les Technologies Associées - ULR 7365 [GRITA]
Guery, Benoit [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Dervaux, Benoit [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]

Journal title :

PLoS One

Abbreviated title :

PLoS One

Volume number :

12

Publication date :

2017-01-19

ISSN :

1932-6203

English keyword(s) :

Mesh:Clostridium difficile*
Mesh:Aminoglycosides/economics
Mesh:Aminoglycosides/therapeutic use
Mesh:Anti-Bacterial Agents/economics
Mesh:Vancomycin/therapeutic use
Mesh:Vancomycin/economics
Mesh:Recurrence
Mesh:Quality-Adjusted Life Years
Mesh:Models
Mesh:Economic
Mesh:Humans
Mesh:Health Care Costs
Mesh:France
Mesh:Fecal Microbiota Transplantation/methods
Mesh:Fecal Microbiota Transplantation/economics
Mesh:Enterocolitis
Mesh:Pseudomembranous/therapy*
Mesh:Enterocolitis
Mesh:Pseudomembranous/economics*
Mesh:Decision Trees
Mesh:Cost-Benefit Analysis
Mesh:Computer Simulation
Mesh:Community-Acquired Infections/therapy*
Mesh:Community-Acquired Infections/economics*
Mesh:Anti-Bacterial Agents/therapeutic use

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: Clostridium difficile infection (CDI) is characterized by high rates of recurrence, resulting in substantial health care costs. The aim of this study was to analyze the cost-effectiveness of treatments for the ...
Show more >BACKGROUND: Clostridium difficile infection (CDI) is characterized by high rates of recurrence, resulting in substantial health care costs. The aim of this study was to analyze the cost-effectiveness of treatments for the management of second recurrence of community-onset CDI in France. METHODS: We developed a decision-analytic simulation model to compare 5 treatments for the management of second recurrence of community-onset CDI: pulsed-tapered vancomycin, fidaxomicin, fecal microbiota transplantation (FMT) via colonoscopy, FMT via duodenal infusion, and FMT via enema. The model outcome was the incremental cost-effectiveness ratio (ICER), expressed as cost per quality-adjusted life year (QALY) among the 5 treatments. ICERs were interpreted using a willingness-to-pay threshold of €32,000/QALY. Uncertainty was evaluated through deterministic and probabilistic sensitivity analyses. RESULTS: Three strategies were on the efficiency frontier: pulsed-tapered vancomycin, FMT via enema, and FMT via colonoscopy, in order of increasing effectiveness. FMT via duodenal infusion and fidaxomicin were dominated (i.e. less effective and costlier) by FMT via colonoscopy and FMT via enema. FMT via enema compared with pulsed-tapered vancomycin had an ICER of €18,092/QALY. The ICER for FMT via colonoscopy versus FMT via enema was €73,653/QALY. Probabilistic sensitivity analysis with 10,000 Monte Carlo simulations showed that FMT via enema was the most cost-effective strategy in 58% of simulations and FMT via colonoscopy was favored in 19% at a willingness-to-pay threshold of €32,000/QALY. CONCLUSIONS: FMT via enema is the most cost-effective initial strategy for the management of second recurrence of community-onset CDI at a willingness-to-pay threshold of €32,000/QALY.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2020-02-11T09:07:25Z
2020-03-26T14:02:27Z