Vargas-Palacios, A orcid.org/0000-0002-6503-0134, Meads, D orcid.org/0000-0003-1369-2483, Twiddy, M orcid.org/0000-0002-3794-1598 et al. (6 more authors) (2017) Cost-effectiveness of Outpatient Parenteral Antibiotic Therapy: A Simulation Modelling Approach. Journal of Antimicrobial Chemotherapy, 72 (8). pp. 2392-2400. ISSN 0305-7453
Abstract
Objectives: In the UK, patients who require intravenous antimicrobial (IVA) treatment may receive this in the community through outpatient parenteral antimicrobial therapy (OPAT) services. Services include: IVA administration at a hospital outpatient clinic (HO); IVA administration at home by a general nurse (GN) or a specialist nurse (SN); or patient self-administered (SA) IVA administration following training. There is uncertainty regarding which OPAT services represent value for money; this study aimed to estimate their cost-effectiveness. Methods: A cost-effectiveness decision-analytic model was developed using a simulation technique utilizing data from hospital records and a systematic review of the literature. The model estimates cost per QALY gained from the National Health Service (NHS) perspective for short- and long-term treatment of infections and service combinations across these. Results: In short-term treatments, HO was estimated as the most effective (0.7239 QALYs), but at the highest cost (£973). SN was the least costly (£710), producing 0.7228 QALYs. The combination between SN and HO was estimated to produce 0.7235 QALYs at a cost of £841. For long-term treatments, SN was the most effective (0.677 QALYs), costing £2379, while SA was the least costly at £1883, producing 0.666 QALYs. A combination of SA and SN was estimated to produce 0.672 QALYs at a cost of £2128. Conclusions: SN and SA are cost-effective for short- and long-term treatment of infections, while combining services may represent the second-best alternative for OPAT in the UK.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | (c) 2017, The Author. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. This is a pre-copyedited, author-produced PDF of an article published in the Journal of Antimicrobial Chemotherapy following peer review. The version of record, 'Vargas-Palacios, A , Meads, D , Twiddy, M et al (2017). Cost-effectiveness of Outpatient Parenteral Antibiotic Therapy: A Simulation Modelling Approach. Journal of Antimicrobial Chemotherapy, 72 (8). pp. 2392-2400,' is available online at: https://doi.org/10.1093/jac/dkx123 |
Keywords: | cost effectiveness, hospital records, nurses, outpatients, quality-adjusted life years, self administration, infection, antibiotic therapy, antimicrobials, community, national health service (uk) |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Health Economics (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Centre for Health Services Research (Leeds) |
Funding Information: | Funder Grant number NIHR 11/2003/60 |
Depositing User: | Symplectic Publications |
Date Deposited: | 28 Apr 2017 09:17 |
Last Modified: | 15 May 2018 00:38 |
Published Version: | https://academic.oup.com/jac/article/doi/10.1093/j... |
Status: | Published |
Publisher: | Oxford University Press |
Identification Number: | 10.1093/jac/dkx123 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:115732 |