Abstract

VARON, Fabio et al. Cost effectiveness of linezolid compared with vancomycin in the management of ventilator-associated pneumonia in Colombia. Infect. [online]. 2014, vol.18, n.4, pp.143-152. ISSN 0123-9392.  https://doi.org/10.1016/j.infect.2014.09.002.

Objective: To estimate the cost-effectiveness of linezolid versus vancomycin in the management of ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA) in Colombia. Materials and methods: We constructed a decision tree to determine the incremental cost effectiveness ratio (ICER) of linezolid (600 mg iv /12 h) compared to vancomycin (15 mg/kg iv/12 h) for the treatment of VAP caused for MRSA. The perspective is that of the Colombian health system, including only direct costs. All currency units are in Colombian pesos (COP, 2013) with no discount. (1 USD = $1,876.22). We used a time horizon of 30 days. The results were measured in the proportion of patients cured. The efficacy and safety data were taken from the literature. The costs of procedures were obtained of ISS tariff manual of 2001 and for drugs current price regulations and the SISMED database were used. Univariate and probabilistic sensitivity analyses were performed. Results: The total costs expected per patient cured were COP 2,600,094 for linezolid and COP 1,992,753 for vancomycin. The proportion of cured patients was 53% with linezolid and 41% with vancomycin. The ICER of linezolid compared with vancomycin was COP 5,061,173 per patient cured. For each alternative, the results were sensitive to the probability of the success of treatment, the probability of adverse events and the cost of treatment. Conclusion: Linezolid would be a cost-effective alternative in the treatment of VAP for MRSA in Colombia for willingness to pay above COP 5,061,173 per patient cured.

Keywords : Cost-effectiveness analysis; Mechanical ventilator Associated pneumonia; Linezolid; Vancomycin; Colombia.

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