OBJECTIVE

To assess the pharmacoeconomic effectiveness of ceftazidime + avibactam administration in the treatment of nosocomial pneumonia caused by carbapenem-resistant Enterobacteriacea and complicated by bacteremia.

MATERIAL AND METHODS

The target population of patients was determined according to the data of the State report “On the state of sanitary-epidemiological well-being of population in the Russian Federation in 2017”. We took into account direct costs of antibiotic therapy schemes described in the current clinical guidelines (including ceftazidime + avibactam and colistin + tigecycline + carbapenem), costs of management of side effects (renal failure) and hospital-stay. Minimal selling prices of manufacturers were used. We analyzed cost and effectiveness, impact on the budget and sensitivity of the results. The period of the study was 3 years.

RESULTS

Administration of ceftazidime + avibactam (zavicefta) for nosocomial infections (pneumonia) caused by carbapenem-resistant Enterobacteriacea and complicated by bacteremia increases 30-day survival rate from 68% to 91% in comparison with the applied antibacterial treatment regimens, reduces the cost of antibacterial therapy from 267,646-359,703 rubles up to 215,450 rubles (24.2-69.2%), minimizes the total costs of healthcare system from 751,067-847,917 rubles up to 430,068 rubles (42.7-49.3%), reduces financial load on the healthcare system within 3 years up to 1108.1 million rubles (47.73%). Prescription of a combined drug ceftazidime + avibactam is a dominant alternative reducing the cost of preserving the patient’s life within 30-day period by 57.2-62.1%.

CONCLUSION

Administration of a combined drug of ceftazidime + avibactam for nosocomial pneumonia caused by carbapenem-resistant Enterobacteriacea and complicated by bacteremia is pharmacoeconomically feasible approach. This medication simultaneously improves survival of patients and reduces the costs of healthcare system.