Estimating the Clinical and Economic Impact of Introducing a New Antibacterial into Greek Clinical Practice for the Management of Hospital-Acquired Infections with Limited Treatment Options

Abstract

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.

Clinical and Economic Value of Reducing Antimicrobial Resistance in the Management of Hospital-Acquired Infections with Limited Treatment Options in Greece

“…Thus, a fully funded and supported AMR national action plan which encompasses the objectives of the WHO Global Action Plan on Antimicrobial Resistance and the key issues driving infection resistance in Greece, including overuse, misuse, and an insufficient antimicrobial pipeline, should be imminent. The benefits of introducing new antimicrobial treatment in Greece has previously been quantified and supports the implementation of an action plan that also aims to incentivise research and development and timely access to new antimicrobials [ 25 ].…”

“…However, whilst these attempts have been made by policy makers to implement AMR control, a Greek AMR national action plan in line with the objectives of the WHO’s Global Action Plan on Antimicrobial Resistance is yet to be fully implemented [ 24 ]. The economic and clinical value of introducing a new antimicrobial in Greece has previously been investigated and supports the implementation of an action plan which incentivises and improves access to new antibacterial treatments [ 25 ]. This study aims to supplement the previous modelling work by adopting a broader view to understand the current AMR burden in Greece and the value of reducing current AMR levels to four major gram-negative pathogens to highlight the clinical and economic benefits that may be achieved and the need to address AMR as imminent threat to public health in Greece.…”

Quantifying the Economic and Clinical Value of Reducing Antimicrobial Resistance in Gram-negative Pathogens Causing Hospital-Acquired Infections in Australia

“…It is important to note that the research presented here does not attempt to estimate the value of a new antimicrobial, so the STEDI framework is not fully applicable; however, we could have considered the impact of reducing AMR on enablement value. There have been previous efforts to estimate the value of antimicrobials taking into consideration transmission and diversity value, and future research efforts are required to estimate the enablement, spectrum and insurance value [ 18 , 39 , 40 ]. This highlights the need to explore alternative reimbursement frameworks that could encourage their commercialisation, once approved within Australia.…”

Healthcare-associated infections in the intensive care unit

“…quality-adjusted life years -QALY) i godine života korigovane u odnosu na nesposobnost (engl. disability adjusted life-years -DALYs), koji se koriste za poređenje efikasnosti intervencija, uključujući i intervencije za sprečavanje BI (36,37). U Srbiji do sada ekonomske analize vezane za problem BI nisu sprovođene.…”