Pharmacoeconomics Assessment of cost-effectiveness for the treatment of Community-Acquired Pneumonia and Chronic Bronchitis Exacerbations with gemifloxacin in patients attended at the Instituto Mexicano del Seguro Social

Abstract

Objective: To assess effectiveness and associated costs to antibacterial treatments used within ambulatory and inpatient services in patients with community-acquired pneumonia (CAP) and acute exacerbations of chronic bronchitis (AECB) from the Social Security Mexican Institute perspective (IMSS). Methods: Cost-Effectiveness Evaluation: Decision tree models and a Markov model (AECB recurrences) were performed. Comparators were levofloxacin, gatifloxacin, moxifloxacin, amoxicilin, clarithromycin, ceftriaxone, cefuroxime versus gemifloxacin. Effectiveness measure was the clinical successful rate. Results: The effectiveness among all antimicrobials in comparison varied between 83 y 98%, and in all scenarios the highest effectiveness was for gemifloxacin. When evaluating the months free of recurrence in patients with AECB, gemifloxacin remained an average of 11.12 free-months. Ambulatory treatment costs was estimated among €179, 89 and €205, 47, been gemifloxacin the less costly. Within the hospital setting the estimated costs were between €1.814, 36 and €4.817.57, been gemifloxacin the less costly alternative. Therefore, gemifloxacin result the most cost-effectiveness option dominating the rest of the analyzed treatments, even in the sensitivity analyses changing its costs, effectiveness levels and adverse events rates. Conclusion: Gemifloxacin resulted the most cost-effectiveness option for the treatment of CAP and AECB using a time horizon of three months and remained patients with CBE free of recurrences for a longer period of time during a year.