Evidence map›Paper›PMID 37093359›Full record

ArticleAdvances in therapy2023

Cost-Effectiveness Analysis of REBYOTA™ (Fecal Microbiota, Live-jslm [FMBL]) Versus Standard of Care for the Prevention of Recurrent Clostridioides difficile Infection in the USA.

Thomas Lodise, Amy Guo, Min Yang, Erin E Cook, Wei Song, Danni Yang, Qingyuan Wang, Angela Zhao, Markian Bochan

Open access · hybridAbstract read
In one paragraph

Article in Advances in therapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 16 citations in OpenAlex.

  1. Review
  2. Clinician Management Preferences forOpen forum infectious diseases · 2025
    Article
  3. The evolving landscape of live biotherapeutics in the treatment of Clostridioides difficile infection.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025
    Review
  4. Navigating recurrentAntimicrobial stewardship & healthcare epidemiology : ASHE · 2025
    Article
  5. Review
  6. Review
  7. Microbiota restoration therapies for recurrentTherapeutic advances in gastroenterology · 2024
    Review
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 3 countries.

Thomas LodiseAlbany College of Pharmacy and Health Sciences, Albany, NY, USA.
Amy GuoHEOR & RWE, Medical Affairs, Ferring Pharmaceuticals, Inc., 100 Interpace Parkway, Parsippany, NJ, 07054, USA. amy.guo@ferring.com.ORCID http://orcid.org/0000-0003-0180-3844
Min YangAnalysis Group, Boston, MA, USA.
Erin E CookAnalysis Group, Boston, MA, USA.
Wei SongAnalysis Group, Boston, MA, USA.
Danni YangAnalysis Group, Boston, MA, USA.
Qingyuan WangAnalysis Group, London, UK.
Angela ZhaoAnalysis Group, Boston, MA, USA.
Markian BochanOutpatient Integrated Strategies, Carmel, IN, USA.
Analysis Group (United States) · USAlbany College of Pharmacy and Health Sciences · USFerring Pharmaceuticals (Switzerland) · CHInstitute of Group Analysis · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRecurrent Clostridioides difficile infection (rCDI) is common and associated with considerable clinical and economic consequences. REBYOTA™ (fecal microbiota, live-jslm [FMBL]) is a microbiota-based live biotherapeutic approved for the prevention of rCDI following antibiotic treatment for rCDI. We sought to evaluate cost-effectiveness of FMBL compared to standard of care (SOC) from a US third-party payer perspective among patients with one or more (≥ 1) recurrences.

methodsA Markov model with a lifetime time horizon was developed. The model population included adult patients who had ≥ 1 recurrence after a primary CDI episode and had completed ≥ 1 round of antibiotics, or had ≥ 2 severe CDI episodes resulting in hospitalization within the last year. The model consisted of six health states with an 8-week model cycle: rCDI, absence of CDI after recurrence, colectomy, ileostomy, ileostomy reversal, and death. Drug costs and rCDI-related medical costs were estimated in 2022 US dollars and discounted at 3% annually. Deterministic sensitivity analyses were performed.

resultsCompared to SOC, FMBL at $9000/course resulted in an incremental cost-effectiveness ratio (ICER) of $18,727 per quality-adjusted life year (QALY) gained. The incremental cost was $5336 (FMBL $79,236, SOC $73,900) and the incremental effectiveness was 0.285 QALYs (FMBL 10.346, SOC 10.061). The cumulative drug acquisition and administration costs for the FMBL and SOC arms were $24,245 and $16,876, while rCDI-related medical costs for FMBL and SOC were $54,991 and $57,024, respectively. The ICER in the subgroup of patients at first recurrence was $13,727 per QALY gained. FMBL remained cost-effective across all sensitivity analyses.

conclusionsFMBL was found to be cost-effective compared to SOC for the prevention of rCDI with more benefits among patients at first recurrence, with an ICER far below the payer ICER threshold of $100,000. Patients treated with FMBL experienced higher total QALYs and reduced healthcare resource utilization, including reduced hospitalizations.

Indexed as

Clostridioides difficileClostridium InfectionsAdultAnti-Bacterial AgentsCost-Benefit AnalysisCost-Effectiveness AnalysisHumansRecurrenceStandard of CareUnited StatesAnti-Bacterial AgentsCost-effectiveness analysisEconomic modelingFMBLLive fecal microbiotaREBYOTARecurrent Clostridioides difficile infection

Identifiers

PMID37093359
PMCPMC10220097
OpenAlexW4366821708

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.