Thitima Kongnakorn

Economic Evaluation of Atorvastatin for Prevention of Recurrent Stroke Based on the SPARCL Trial

OBJECTIVES This study evaluated the economic implications of results obtained by the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. METHODS To enable long-term projection of the trial results, a discrete event simulation of the course of clinical care after a recent stroke or transient ischemic attack (TIA) was developed. It generates pairs of identical patients; both receive usual care, one receives atorvastatin in addition. Their clinical course is simulated based on their risk of stroke, cardiovascular events, and case fatality rates taken from SPARCL, life expectancy from Saskatchewan Health data, and utility weights from literature. Costs, from a US health-care payer perspective in 2005 US dollars, were estimated for a within-trial 5-year period; survival and quality-adjusted life-years (QALYs) were extrapolated over a patients lifetime; all discounted at 3%/year. RESULTS The prevention of stroke, coronary, and other cardiovascular events expected with atorvastatin translates to mean gains of 0.155 life-years gained and 0.172 QALYs per patient over their lifetime. Reducing associated medical costs (

Economic evaluation of doripenem for the treatment of nosocomial pneumonia in the US: discrete event simulation

8405 vs.

Modeling economic implications of alternative treatment strategies for acute bacterial skin and skin structure infections

11,237) but increasing drug costs (

Economic implications of using bendamustine, alemtuzumab, or chlorambucil as a first-line therapy for chronic lymphocytic leukemia in the US: a cost-effectiveness analysis

13,984 vs.

Economic Implications of Alternative Treatments and Care Locations for Acute Bacterial Skin and Skin Structure Infections with Suspected MRSA

8752) results in net

PDB40 SIMULATION OF LONG-TERM COSTS OF COMPLICATIONS IN TYPE II DIABETES IN THE UNITED STATES

2400/patient, or

Original article Modeling economic implications of alternative treatment strategies for acute bacterial skin and skin structure infections

13,916/QALY gained. Probabilistic sensitivity analysis indicates no simulations yield ratios above

Modeling the economic implications of alternative treatments and care locations for acute bacterial skin and skin structure infections: Results from a discrete event simulation

50,000/QALY. CONCLUSION Prescribing atorvastatin for patients with prior stroke or TIA is expected to provide health benefits at an acceptable cost in the United States.

PIN35 ECONOMIC EVALUATION OF CEFTOBIPROLE FOR THE TREATMENT OF COMPLICATED SKIN AND SKIN STRUCTURE INFECTIONS IN THE UNITED STATES

Abstract Objective: Patients with nosocomial pneumonia, particularly associated with ventilator use, are at an increased risk of death and further morbidity. Doripenem is a new broad-spectrum carbapenem that is approved for complicated intra-abdominal infection and complicated urinary tract infection and is under the Food and Drug Administration (FDA)’s review for nosocomial pneumonia and ventilator-associated pneumonia in the United States (US). The economic implications of this new antibiotic, relative to imipenem for treatment of nosocomial pneumonia, were investigated. Research design and methods: An economic model of the clinical course of nosocomial pneumonia after initiation of treatment was developed using discrete event simulation. Pairs of identical patients are generated; one receives doripenem and the other receives imipenem. Their clinical course is simulated using clinical trial data on treatment response, seizure rates, mortality, length of hospital and intensive care unit stays, days on mechanical ventilation, and emerging Pseudomonas aeruginosa (PsA) resistance; published treatment and hospital costs; and PsA transmission risk. Analyses of 10,000 patients per treatment for 100 replications were performed. From the perspective of a comprehensive payer, costs – in 2007 US Dollars (USDs) – were estimated for a treatment episode (35–49 days) without discounting. Study limitation includes clinical trial-driven design of the model in which some aspects may not represent actual practice; some assumptions around efficacy data due to data unavailability; and lack of consideration of factors that impact disease transmission such as hospital environment, hospital size, and hospital infection control as these analyses were not intended for any specific healthcare institution. Results: Doripenem yielded an average of approximately

PCN93 COST-EFFECTIVENESS ANALYSIS OF BENDAMUSTINE COMPARED TO ALEMTUZUMAB AND CHLORAMBUCIL FOR CHRONIC LYMPHOCYTIC LEUKEMIA IN A TREATMENT-NAIVE POPULATION

7000 in savings per patient compared to imipenem, with 95% driven by reduction in hospital length of stay. The model predicted 63% fewer seizures, 52% fewer emerging PsA resistance, and 15% shorter stays leading to 46% fewer transmissions associated with doripenem. Conclusion: Using doripenem for treatment of nosocomial pneumonia is expected to yield significant savings compared to imipenem use in the US.