Pharmacoeconomic comparison of cefepime vs. Ceftazidime in septic patients

A pharmacoeconomic analysis of two consecutive randomized, controlled clinical trials of cefepime vs. ceftazidime was conducted. Cost-effectiveness analysis compared resource utilization between treatment groups from the institutional perspective. Decision analysis was utilized to model the economic study. At the time of this economic study, a price for cefepime had not been established, so a competitive price was estimated; appropriate sensitivity analyses were applied to the data. The two groups (cefepime N = 44, ceftazidime N = 47) were similar in demographic characteristics, infection sites, and clinical outcome. Base hospital bed costs accounted for approximately 65% of costs while antibiotic acquisition, preparation, and administration had minimal impact on overall costs. Patients who expired had increased mean costs of $4088 (p = 0.011). There were $6150 in health care resources consumed for each treatment success in the cefepime group, compared to $6688 for the ceftazidime group. The difference was largely due to a decreased duration of hospitalized therapy for patients in the cefepime group. Sensitivity analysis revealed the economic decision would change if the efficacy rate of ceftazidime was at least 12% greater than that of cefepime. Otherwise, if priced within the range of our sensitivity analysis, cefepime will be a cost-effective treatment option.