6 PHARMACOECONOMICS Cotrimoxazole favoured for PCP prophylaxis

Use of cotrimoxazole [trimetboprirnlsulfametboxazole] as secondary prophylaxis for newly diagnosed cases of Pneumocystis carinii pneumonia (PCP) could result in annual savings of over $US 17.4 million compared with use of aerosolised pentamidine, according to US researchers.

The researchers used a literature-based model, which was subsequently refined using efficacy and toxicity data from a controlled clinical trial. The literature-based model found incremental cost­effectiveness ratios of $US350 for cotrimoxazole, and $US2950 for pentamidine, per life-year saved. The trial-based model assessed these ratios at $US720 and 3800, respectively. Results were robust across a wide range of toxicity estimates and costs.

The researchers note that new and often costly interventions in the area of AIDS treatment arise at too fast a rate for clinical trials to keep pace in assessing their appropriate use. Literature-based models can be used to provide estimates of the cost effectiveness of these new strategies, which can then be revised in the light of subsequent trials.

Freedb<rg !CA. Hardy WD, Holzman RS, Tosteson ANA, Craven DE. et aI. Validating literature-based models with direct clinical trial results: the

cost-effectiveness of secondary prophylaxis for PCP in AIDS patients. Medical Decision Making 16: 29-35. Jan-Mar 1996 ..... ..."

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