Economic evaluation of fecal microbiota transplantation for the treatment of recurrent Clostridium difficile infection in Australia.
J Gastroenterol Hepatol
; 31(12): 1927-1932, 2016 Dec.
Article
em En
| MEDLINE
| ID: mdl-27043242
ABSTRACT
BACKGROUND AND AIM:
Clostridium difficile is the most common cause of hospital-acquired diarrhea in Australia. In 2013, a randomized controlled trial demonstrated the effectiveness of fecal microbiota transplantation (FMT) for the treatment of recurrent Clostridium difficile infection (CDI). The aim of this study is to evaluate the cost-effectiveness of fecal microbiota transplantation-via either nasoduodenal or colorectal delivery-compared with vancomycin for the treatment of recurrent CDI in Australia.METHODS:
A Markov model was developed to compare the cost-effectiveness of fecal microbiota transplantation compared with standard antibiotic therapy. A literature review of clinical evidence informed the structure of the model and the choice of parameter values. Clinical effectiveness was measured in terms of quality-adjusted life years. Uncertainty in the model was explored using probabilistic sensitivity analysis.RESULTS:
Both nasoduodenal and colorectal FMT resulted in improved quality of life and reduced cost compared with vancomycin. The incremental effectiveness of either FMT delivery compared with vancomycin was 1.2 (95% CI 0.1, 2.3) quality-adjusted life years, or 1.4 (95% CI 0.4, 2.4) life years saved. Treatment with vancomycin resulted in an increased cost of AU$4094 (95% CI AU$26, AU$8161) compared with nasoduodenal delivery of FMT and AU$4045 (95% CI -AU$33, AU$8124) compared with colorectal delivery. The mean difference in cost between colorectal and nasoduodenal FMT was not significant.CONCLUSIONS:
If FMT, rather than vancomycin, became standard care for recurrent CDI in Australia, the estimated national healthcare savings would be over AU$4000 per treated person, with a substantial increase in quality of life.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Enterocolite Pseudomembranosa
/
Clostridioides difficile
/
Custos de Cuidados de Saúde
/
Transplante de Microbiota Fecal
/
Microbioma Gastrointestinal
/
Intestinos
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Health_economic_evaluation
/
Prognostic_studies
Limite:
Humans
País/Região como assunto:
Oceania
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article