Costo-utilità di dalbavancina versus standard of care (SoC) in pazienti con ABSSSI non severa in Italia

Abstract

Introduction: Acute Bacterial Skin and Skin Structure Infections (ABSSSIs) include all complicated skin and soft tissue infections. The aim of this study was to conduct a cost-utility analysis to compare dalbavancin with standard antibiotic therapies for the management of non-severe ABSSSIs from the National Health Service (NHS) perspective.
 Methods: A probabilistic decision tree model was developed considering a 30-days follow-up to simulate the therapeutic pathway of a patient treated with dalbavancin or Standard of Care (SoC). The model considered three mutually exclusive health states: a) discharge of patients from the emergency department, b) discharge of patients after one night from admission, c) discharge after 24 or 36 hours from admission. A one-way deterministic sensitivity analysis and a probabilistic sensitivity analysis were conducted.
 Results: The analysis showed that the use of dalbavancin in patients with non-severe ABSSSI compared to SoC could generate a reduction in costs (– € 291.6 per patient treated) and an increase in QALYs (+0.0018 per patient treated). In 99.7% of the simulations carried out, dalbavancin was dominant compared to the SoC. Considering a threshold for the willingness to pay of € 30,000 for QALY gained, the minimum level of efficacy of dalbavancin so that the treatment can be considered cost-effective compared to the SoC was equal to 69.4%.
 Conclusions: The analysis showed that dalbavancin may represent a cost-effective option compared to SoC for the treatment of patients with non-severe ABSSSI.

Clinical, organizational, and pharmacoeconomic perspectives of dalbavancin vs standard of care in the infectious disease network

“…In a previous study, a cost-utility analysis of dalbavancin for the management of non-severe ABSSSIs from the NHS perspective was conducted by comparing data regarding dalbavancin with the standard of care (SoC). For the study, a probabilistic decision tree model was developed considering a 30-days follow-up to simulate the therapeutic pathway of a patient treated with dalbavancin or SoC ( 17 ). The model considered three mutually exclusive health states: (a) discharge of patients from the emergency department, (b) discharge of patients after one night from admission, (c) discharge after 24 or 36 hours from admission.…”

“…In 99.7% of the simulations carried out, dalbavancin was dominant compared to the SoC. The analysis showed that dalbavancin may represent a cost-effective option compared to SoC for the treatment of patients with non-severe ABSSSI ( 17 ).…”

Place in therapy of dalbavancin to treat Gram-positive infections in antimicrobial resistance era: an overview

“…The promising efficacy in these challenging, off-label scenarios makes dalbavancin a viable alternative to daily intravenous or outpatient antimicrobial regimens. The simplified single or weekly administration regimen allows an early discharge, especially when adherence to oral therapy cannot be guaranteed or no oral choices are available ( 28 , 29 ).…”