Evidence map›Paper›PMID 39209783›Full record

ArticleBMJ open2024

Estimating the value of new antibiotic treatment strategies in Zhejiang province, China: cost-effectiveness analysis based on a validated dynamic model.

Wenqianzi Yang, Xuemei Zhen, Xueshan Sun, Shikha Upadhyaya Khatiwada, Danhong Yang, Yixi Chen, Peng Dong, Amer Al-Taie, Jason Gordon, Hengjin Dong

Abstract read
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. 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

10 authors.

Wenqianzi Yang *Department of Science and Education of the Fourth Affiliated Hospital and School of Public Health, Center for Health Policy Studies, Zhejiang University School of Medicine, Hangzhou, China.
Xuemei Zhen *Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (NHC Key Laboratory of Health Economics and Policy Research), Shandong University, Jinan, China.
Xueshan SunSchool of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
Shikha Upadhyaya KhatiwadaDepartment of Science and Education of the Fourth Affiliated Hospital and School of Public Health, Center for Health Policy Studies, Zhejiang University School of Medicine, Hangzhou, China.
Danhong YangZhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.
Yixi ChenPfizer Investment Co. Ltd, Beijing, China.
Peng DongPfizer Investment Co. Ltd, Beijing, China.
Amer Al-TaiePfizer R&D UK Limited, Tadworth, UK.
Jason GordonHealth Economics and Outcomes Research Ltd, Cardiff, UK.
Hengjin DongDepartment of Science and Education of the Fourth Affiliated Hospital and School of Public Health, Center for Health Policy Studies, Zhejiang University School of Medicine, Hangzhou, China donghj@zju.edu.cn.ORCID 0000-0002-5064-7297

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis analysis aims to better reflect the value of new antibiotic treatment strategies, thereby informing clinical antibiotic use, antimicrobial reimbursement and/or hospital formulary decision-making in China.

designWe adapted a published and validated dynamic disease transmission and cost-effectiveness model to evaluate the clinical and economic outcomes of introducing a new antibiotic, ceftazidime/avibactam (CAZ-AVI) for treating resistant infections in Zhejiang province, China. Outcomes were assessed over a 10-year infectious period and an annual discount rate of 5%. Costs were extracted from the hospital's Health Information System (HIS) and obtained after data cleaning, aggregation and discounting.

settingThe Chinese healthcare system perspective.

participants10 905 patients in a Chinese tier-3 hospital from 2018 to 2021 with any of the three common infections (complicated intra-abdominal infection (cIAI), hospital-acquired/ventilator-associated pneumonia (HAP/VAP) and infections with limited treatment options (LTO)) caused by three common resistant pathogens (

interventions(1) Current treatment strategy (piperacillin-tazobactam (pip/taz) and meropenem); (2) CAZ-AVI at the third line; (3) CAZ-AVI at the second line; (4) CAZ-AVI at the first line; (5) CAZ/AVI first line, two lines diversified (i.e., equal pip/taz and CAZ-AVI at the first line; meropenem at the last line) and (6) CAZ/AVI first line, all-lines diversified. PRIMARY OUTCOME MEASURES: Quality-adjusted life years (QALYs) lost, hospitalisation costs and incremental net monetary benefit (INMB) were used to assess cost-effectiveness.

resultsOver 10 years, the introduction of CAZ-AVI to the current treatment strategy led to lower hospitalisation costs and more QALYs across all five treatment strategies, with between 68 284 and 78 571 QALYs gained whilst saving up to US$236.37 for each additional QALY gained. The INMB of introducing CAZ-AVI is estimated up to US$3 550 811 878.

conclusionsIntroducing CAZ-AVI had a positive impact on clinical and economic outcomes for treating antimicrobial resistance, and diversifying the antibiotics use early in the treatment might yield the best benefits.

Indexed as

Anti-Bacterial AgentsAzabicyclo CompoundsCeftazidimeCost-Benefit AnalysisChinaCost-Effectiveness AnalysisDrug CombinationsHumansModels, EconomicQuality-Adjusted Life YearsAnti-Bacterial Agentsavibactam, ceftazidime drug combinationAzabicyclo CompoundsCeftazidimeDrug Combinationsanti-bacterial agentshealth economicspublic health

Identifiers

PMID39209783
PMCPMC11367305

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.