Introduction Hospital-acquired infections (HAIs) and growing antimicrobial resistance (AMR) represent a significant healthcare burden globally. Especially in Greece, HAIs with limited treatment options (LTO) pose a serious threat due to increased morbidity and mortality. This study aimed to estimate the clinical and economic value of introducing a new antibacterial for HAIs with LTO in Greece. Methods A previously published and validated dynamic model of AMR was adapted to the Greek setting. The model estimated the clinical and economic outcomes of introducing a new antibacterial for the treatment of HAIs with LTO in Greece. The current treatment pathway was compared with introducing a new antibacterial to the treatment sequence. Outcomes were assessed from a third-party payer perspective, over a 10-year transmission period, with quality-adjusted life years (QALYs) and life years (LYs) gained considered over a lifetime horizon. Results Over the next 10 years, HAIs with LTO in Greece account for approximately 1.4 million hospital bed days, hospitalisation costs of more than €320 million and a loss of approximately 403,000 LYs (319,000 QALYs). Introduction of the new antibacterial as first-line treatment provided the largest clinical and economic benefit, with savings of up to 93,000 bed days, approximately €21 million in hospitalisation costs and an additional 286,000 LYs (226,000 QALYs) in comparison to the current treatment strategy. The introduction of a new antibacterial was linked to a monetary benefit of €6.8 billion at a willingness to pay threshold of €30,000 over 10 years. Conclusion This study highlights the considerable clinical and economic benefit of introducing a new antibacterial for HAIs with LTO in Greece. This analysis shows the additional benefit when a new antibacterial is introduced to treatment sequences. These findings can be used to inform decision makers to implement policies to ensure timely access to new antibacterial treatments in Greece. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-022-00743-4.
the social perspective was chosen for the Netherlands and the third-party payer perspective for the UK. In the sensitivity analyses the robustness of the results were tested and various additional scenario analyses were conducted. Results: After screening titles, abstracts and full-text papers only three (out of sixteen) studies for the Netherlands and six (out of 25) studies for the UK remained. In the base case analysis for the Netherlands (mean incidence: 3.4%; Vaccine Efficacy (VE):50%), EJPs of V5.36 (95% CI,-0.09-16.95) and V21.27 (95% CI, 9.05-45.62) were found for the acquisition costs, corresponding with the lower and higher WTP respectively. In the base case analysis for the UK (mean incidence: 6.6%; VE:50%), EJPs of £16.53 (95% CI, 7.67-27.5) and £42.72 (95% CI, 24.90-65.76) were found for the acquisition costs corresponding the lower and higher WTP respectively. Conclusions: An RSV vaccine may be cost-effective in both the Netherlands and the UK, depending on the VE, vaccine price and the RSV incidence.
Introduction Antimicrobial resistance (AMR) is a major public health threat worldwide. Greece has the highest burden of infections due to antibiotic-resistant bacteria among European Union/European Economic Area (EU/EEA) countries. One of the most serious AMR threats in Greece is hospital-acquired infections (HAIs) with limited treatment options (LTO) caused by resistant gram-negative pathogens. Thus, this study sought to estimate the current AMR burden in Greece and the value of reducing AMR to gram-negative pathogens for the Greek healthcare system. Methods The current model was adapted from a previously published and validated model of AMR to investigate the overall and AMR-specific burden of treating the most common HAIs with LTO in Greece and scenarios to demonstrate the benefits associated with reducing AMR levels from a third-party payer perspective. Clinical and economic outcomes were estimated over a 10-year time horizon; life years (LYs) and quality-adjusted life years (QALYs) were calculated over a lifetime (based on the annual number of infections over 10 years) at a willingness-to-pay of €30,000 per QALY gained and a 3.5% discount rate. Results In Greece, the current AMR levels in HAIs with LTO caused by four gram-negative pathogens account for > 316,000 hospital bed days, €73 million in hospitalisation costs, and > 580,000 LYs and 450,000 QALYs lost over 10 years. The monetary burden is estimated at €13.9 billion. A reduction in current AMR levels by 10–50% results in clinical and economic benefit; 29,264–151,699 bed days may be saved, leading to decreased hospitalisation costs (€6.8 million–€35.3 million) and a gain in LYs (85,328–366,162) and QALYs (67,421–289,331), associated with a monetary benefit of between €2.0 billion and €8.7 billion. Conclusion This study shows the substantial clinical and economic burden AMR represents to the Greek healthcare system and the value that can be achieved by effectively reducing AMR levels. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-023-00837-7.
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