PharmacoEconomics & Outcomes News 680 - 15 Jun 2013 Fidaxomicin for CDI not cost effective at current cost Fidaxomicin for the treatment of patients with Clostridium difficile infection (CDI) is not cost effective at its current cost and current CDI epidemiologic conditions, with the NAP1/BI/027 strain accounting for approximately 50% of isolates. This is the main finding of a US study that determined the economic value of fidaxomicin for the treatment of a first CDI episode or first recurrence from a third-party payer perspective. The researchers developed a decision-analytic simulation model to compare three treatment options, given at recommended doses: fidaxomicin for all patients regardless of disease severity and C. difficile strain; fidaxomicin for patients with negative results from NAP1/BI/027 strain typing (metronidazole or vancomycin for those with positive results); and no fidaxomicin (metronidazole or vancomycin for all patients depending on disease severity). The incremental costs for fidaxomicin based on strain- typing results, given current conditions, was estimated at > $US43.7 million (2012 value) per QALY. The strategy of treating all patients with fidaxomicin was less effective and more costly compared with the other two treatment strategies. Sensitivity analyses showed that fidaxomicin would need to cost ≤ $150 (current cost $3360) to be cost effective in the treatment of all patients, and $160–$400 to be cost effective in the treatment based on strain typing. Bartsch SM, et al. Is Fidaxomicin worth the cost? An economic analysis. Clinical Infectious Diseases : 23 May 2013. Available from: URL: http:// dx.doi.org/10.1093/cid/cit346 803088279 1 PharmacoEconomics & Outcomes News 15 Jun 2013 No. 680 1173-5503/10/0680-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Fidaxomicin for CDI not cost effective at current cost

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PharmacoEconomics & Outcomes News 680 - 15 Jun 2013

Fidaxomicin for CDI not costeffective at current cost

Fidaxomicin for the treatment of patients withClostridium difficile infection (CDI) is not cost effectiveat its current cost and current CDI epidemiologicconditions, with the NAP1/BI/027 strain accounting forapproximately 50% of isolates.

This is the main finding of a US study that determinedthe economic value of fidaxomicin for the treatment of afirst CDI episode or first recurrence from a third-partypayer perspective. The researchers developed adecision-analytic simulation model to compare threetreatment options, given at recommended doses:fidaxomicin for all patients regardless of disease severityand C. difficile strain; fidaxomicin for patients withnegative results from NAP1/BI/027 strain typing(metronidazole or vancomycin for those with positiveresults); and no fidaxomicin (metronidazole orvancomycin for all patients depending on diseaseseverity).

The incremental costs for fidaxomicin based on strain-typing results, given current conditions, was estimatedat > $US43.7 million (2012 value) per QALY. Thestrategy of treating all patients with fidaxomicin was lesseffective and more costly compared with the other twotreatment strategies. Sensitivity analyses showed thatfidaxomicin would need to cost ≤ $150 (current cost$3360) to be cost effective in the treatment of allpatients, and $160–$400 to be cost effective in thetreatment based on strain typing.Bartsch SM, et al. Is Fidaxomicin worth the cost? An economic analysis. ClinicalInfectious Diseases : 23 May 2013. Available from: URL: http://dx.doi.org/10.1093/cid/cit346 803088279