is fmt cost effective inc

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PharmacoEconomics & Outcomes News 706, p9 - 5 Jul 2014 Is FMT cost effective in C. difficile infection? Two US studies, presented at the 19th Annual International Meeting of the International Society for Pharmacoeconomics and Outcomes, investigated the cost effectiveness of various strategies, including faecal microbiota transplantation (FMT), in the treatment of Clostridium difficile infection (CDI). The first study, conducted at the Universities of Utah and Pittsburgh, showed that FMT was more costly, but more effective in the treatment of initial C. difficile infection than a 10- to 14-day course of oral metronidazole ($US1669 vs $1167; 0.242 vs 0.238 QALYs), with an incremental cost of $US124 964/ QALY. 1 FMT was less costly and more effective compared with oral vancomycin ($1890, 0.241 QALYs). The analysis was performed from a 3rd-party payer perspective. One-way sensitivity analyses showed that metronidazole dominated both competing strategies if its probability of cure was > 90%, and FMT dominated if its cost was below $667. The researchers conclude that FMT "is less likely to be economically favorable, and vancomycin is unlikely to be favorable as first-line therapy when compared to FMT, due to higher cost and less effectiveness." The second study, conducted at the University of Southern California, found that using FMT as standard protocol rather than the last resort in the treatment of CDI in patients with recurrent infections is cost effective. 2 Using a cost-effectiveness model from a societal perspective, the analysis showed that FMT was less costly and more effective in the treatment of mild- to-moderate CDI, compared with metronidazole, oral vancomycin and fidaxomicin, reducing costs to $13 537 with an increase to 11.85 QALYs. Similarly, in the treatment of severe CDI, FMT was the dominant treatment option, reducing costs to $13 537 with an increase to 11.84 QALYs. 1. Biltaji E, et al. Cost-Effectiveness Analysis of Treatment Strategies for Initial Clostridium Difficile Infection. 19th Annual International Meeting of the International Society for Pharmacoeconomics and Outcomes : (plus poster) abstr. PGI19, 31 May 2014. 2. Massachi S, et al. Cost-Effectiveness of Various Clostridium Difficile Infection (Cdi) Treatments in Patients with Recurrent Infections. 19th Annual International Meeting of the International Society for Pharmacoeconomics and Outcomes : abstr. PIN50, 31 May 2014. 801085784 1 PharmacoEconomics & Outcomes News 5 Jul 2014 No. 706 1173-5503/14/0706-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved

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Page 1: Is FMT cost effective inC

PharmacoEconomics & Outcomes News 706, p9 - 5 Jul 2014

Is FMT cost effective in C. difficileinfection?

Two US studies, presented at the 19th AnnualInternational Meeting of the International Society forPharmacoeconomics and Outcomes, investigated thecost effectiveness of various strategies, including faecalmicrobiota transplantation (FMT), in the treatment ofClostridium difficile infection (CDI).

The first study, conducted at the Universities of Utahand Pittsburgh, showed that FMT was more costly, butmore effective in the treatment of initial C. difficileinfection than a 10- to 14-day course of oralmetronidazole ($US1669 vs $1167; 0.242 vs0.238 QALYs), with an incremental cost of $US124 964/QALY.1 FMT was less costly and more effectivecompared with oral vancomycin ($1890, 0.241 QALYs).The analysis was performed from a 3rd-party payerperspective. One-way sensitivity analyses showed thatmetronidazole dominated both competing strategies ifits probability of cure was > 90%, and FMT dominated ifits cost was below $667. The researchers conclude thatFMT "is less likely to be economically favorable, andvancomycin is unlikely to be favorable as first-linetherapy when compared to FMT, due to higher cost andless effectiveness."

The second study, conducted at the University ofSouthern California, found that using FMT as standardprotocol rather than the last resort in the treatment ofCDI in patients with recurrent infections is costeffective.2 Using a cost-effectiveness model from asocietal perspective, the analysis showed that FMT wasless costly and more effective in the treatment of mild-to-moderate CDI, compared with metronidazole, oralvancomycin and fidaxomicin, reducing costs to $13 537with an increase to 11.85 QALYs. Similarly, in thetreatment of severe CDI, FMT was the dominanttreatment option, reducing costs to $13 537 with anincrease to 11.84 QALYs.1. Biltaji E, et al. Cost-Effectiveness Analysis of Treatment Strategies for Initial

Clostridium Difficile Infection. 19th Annual International Meeting of theInternational Society for Pharmacoeconomics and Outcomes : (plus poster) abstr.PGI19, 31 May 2014.

2. Massachi S, et al. Cost-Effectiveness of Various Clostridium Difficile Infection(Cdi) Treatments in Patients with Recurrent Infections. 19th AnnualInternational Meeting of the International Society for Pharmacoeconomics andOutcomes : abstr. PIN50, 31 May 2014.

801085784

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PharmacoEconomics & Outcomes News 5 Jul 2014 No. 7061173-5503/14/0706-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved