PIN25 - Cost-Effectiveness Analysis of Fecal Microbiota Transplantation in Patients With Clostridium Difficile Infection in Hong Kong
Refereed conference paper presented and published in conference proceedings

香港中文大學研究人員

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替代計量分析
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其它資訊
摘要Objectives
Clostridium difficile infection (CDI) caused by ribotype 002 strain is associated with poor outcomes in Hong Kong. Fecal microbiota transplantation (FMT) is an effective but costly treatment for CDI. We aimed to examine potential cost-effectiveness of ribotype-guided FMT in patients with initial CDI from the perspective of healthcare provider in Hong Kong.

Methods
A decision-analytic model was designed to simulate outcomes of ribotype-guided FMT versus standard treatment (metronidazole) in patients with initial CDI in the hospital setting. Outcome measures included incidences of recurrence CDI, refractory CDI and mortality; direct medical cost; and quality-adjusted life year (QALY) loss for CDI. Sensitivity analysis was performed to examine robustness of base-case results.

Results
Comparing to standard treatment in base-case analysis, ribotype-guided FMT group reduced mortality (11.4% versus 17.1%), refractory (17.1% versus 17.3%), recurrence CDI (16.4% versus 16.6%), cost (USD9,018 versus USD10,199) (USD1=HKD7.8), and saved 0.486 QALYs. One-way sensitivity analysis found the ribotype-guided FMT group to remain cost-effective when patient acceptance rate of FMT was >0.6% and ribotype 002 prevalence was >0.07%. In probabilistic sensitivity analysis, ribotype-guided FMT gained higher QALYs at 100% of simulations with mean QALY gain of 0.400 QALYs (95%CI: 0.395-0.405; p<0.001). The ribotype-guided group was less costly in 99.86% of time, and mean cost-saving was USA967 (95% CI: 957-977; p<0.001).

Conclusions
Ribotype-guided FMT appears to be effective and cost-saving in patients with initial CDI in Hong Kong. The cost-effectiveness of ribotype-guided FMT is subject to patient acceptance of FMT and prevalence of ribotype with high risk for poor outcomes.
著者Jiang M, Leung N, You J
會議名稱ISPOR Asia Pacific 2018
會議開始日08.09.2018
會議完結日11.09.2018
會議地點Tokyo
會議國家/地區日本
期刊名稱Value in Health
會議論文集題名Value in Health
出版作品名稱VALUE IN HEALTH
出版年份2018
月份9
卷號21
出版社Wiley: No OnlineOpen / Elsevier: 12 months
頁次S65 - S65
國際標準期刊號1098-3015
語言英式英語
Web of Science 學科類別Economics;Health Care Sciences & Services;Health Policy & Services;Business & Economics;Health Care Sciences & Services

上次更新時間 2021-21-01 於 02:14