Full
Outline
To evaluate the cost-effectiveness of imipenem/cilastatin/relebactam (IMI/REL) in patients with hospital-acquired bacterial pneumonia (HABP) and ventilator-associated pneumonia (VAP), using piperacillin/tazobactam (PIP/TAZ) as a comparator, and to assess its economic viability within the Chinese healthcare system.
From the perspective of the Chinese healthcare system, a hybrid decision tree-Markov model was constructed to simulate the long-term health outcomes of IMI/REL and PIP/TAZ from the mean age of disease onset until death. Efficacy and safety data were derived from a Phase Ⅲ clinical trial (NCT03583333), while cost and utility parameters were obtained based on literature reviews and expert interviews. Cost-utility analysis was performed, and one-way and probabilistic sensitivity analyses were conducted to validate the robustness of the results. The unit price of IMI/REL was set at 1 240 yuan per vial based on publicly available sales prices, and which both base-case and scenario analyses were conducted.
The base-case analysis showed that the total treatment cost in the IMI/REL group was 164 275.71 yuan with a quality-adjusted life year (QALY) of 4.32, while the total cost in the PIP/TAZ group was 143 946 yuan with a QALY of 4.13. The incremental cost-utility ratio (ICER) was 104 991.37 yuan per QALY, which was lower than the threshold of three times China's per capita gross domestic product (GDP). The scenario analysis indicated that under the assumption of partial survival among uncured patients, the cost-effectiveness conclusion of IMI/REL remained robust.
Under the currently available price setting, IMI/REL demonstrates favorable cost-effectiveness compared with PIP/TAZ, providing a reference for optimizing treatment strategies and informing medical insurance payment policies for HABP/VAP in China.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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