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Zinplava cost-effective for preventing recurrent CDI
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Zinplava, administered concurrently with antibiotics, was cost-effective in the prevention of recurrent C. difficile infection, or CDI, compared with placebo, according to findings published in Clinical Infectious Diseases.
The FDA approved Zinplava (bezlotoxumab, Merck) for the prevention of recurrent CDI in adult patients last year.
“A significant global economic burden is associated with recurrent CDI, as it is more difficult to treat than initial episodes and is associated with increased morbidity and mortality, more hospitalizations and higher associated costs,” Vimalanand S. Prabhu, PhD, principal scientist at Merck, and colleagues wrote. “Given the significant clinical and economic burden of recurrent CDI, and the ability of bezlotoxumab to reduce recurrent CDI, it is important to assess the cost-effectiveness of bezlotoxumab compared with placebo in preventing CDI among various subgroups of patients receiving [standard of care (SoC)] antibiotics.”
The researchers developed a computer-based Markov health state transition model to track the natural history of patients infected with CDI. A cohort of patients with mild, moderate or severe CDI episodes entered the model, and received treatment with SoC antibiotics, together with either bezlotoxumab or placebo.
The model predicted that the addition of bezlotoxumab in patients receiving SoC antibiotics can reduce the first recurrence by 10.1%, the total number of recurrences by 16.7%, and 180-day mortality by 1.1% compared with placebo. Their analysis showed that the total number of quality-adjusted life years (QALYs) was estimated to increase by 0.12 per patient treated with bezlotoxumab compared with placebo, resulting in an incremental cost-effectiveness ratio (ICER) of $19,824/QALY gained. Bezlotoxumab also demonstrated cost-effectiveness compared with placebo in subgroups of patients aged 65 years and older (ICER of $15,298/QALY), immunocompromised patients (ICER of $12,597/QALY), and patients with severe CDI (ICER of $21,430/QALY).
“A model-based cost-effectiveness analysis has shown that, through prevention of recurrent CDI, bezlotoxumab administered together with SoC antibiotics is cost-effective compared with SoC alone,” Prabhu and colleagues wrote. “Given the urgent population-level threat of CDI identified by the [CDC] and the limited pharmacotherapy options available to prevent recurrent CDI, bezlotoxumab presents itself as a timely intervention to reduce the burden of recurrent CDI.” – by Savannah Demko
Disclosures: Prabhu is employed by Merck and may own stock and/or stock options in the company. Please see the study for all other authors’ relevant financial disclosures.
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