Pharmacoeconomic Evaluation of Amoxicillin-clavulanate Versus Moxifloxacin in the Treatment of Community-acquired Pneumonia

OBJECTIVE  To compare the economics of amoxicillin-clavulanate versus moxifloxacin in the treatment of community-acquired pneumonia (CAP) and to provide a basis for decision-making in the initial empirical treatment of CAP.

METHODS  A retrospective study was conducted to collect medical records of inpatients diagnosed with CAP at the Xiamen Fifth Hospital from January 2022 to December 2022. The patients were divided into 95 cases in group A (amoxicillin-clavulanate) and 106 cases in group B (moxifloxacin) according to the treatment regimen, and a decision tree model was constructed using TreeAge Pro 2022 software to conduct cost-effectiveness and cost-utility analyses of the two medications for the treatment of CAP. The total average cost of the two treatment schemes was used as the willingness-to-pay (WTP) threshold, and the robustness of the results was verified using one-way sensitivity analysis and probabilistic sensitivity analysis.

RESULTS  Group A had an effective rate of 82.11%, an expected cost of 523.34 yuan, and a cost-effectiveness ratio of 6.37; Group B had an effective rate of 93.40%, an expected cost of 252.93 yuan, and a cost-effectiveness ratio of 2.71. The incremental cost of Group A versus Group B was −270.41 yuan, the incremental effectiveness was 0.0840 QALDs, the incremental cost-effectiveness ratio was −3219.17 yuan·QALD⁻¹, which was lower than the value of WTP. Results of one-way sensitivity analysis showed that the cost of amoxicillin-clavulanate treatment after effective, the probability of ineffectiveness after amoxicillin-clavulanate treatment and the probability of effectiveness after moxifloxacin treatment had the greatest influence on the results, but ICER was always greater than the WTP within the floating range of each parameter. The results of the probabilistic sensitivity analysis showed that group B had a greater probability of economy than group A for conditions with WTP thresholds in the interval of 0 to 50000.

CONCLUSION Compared to amoxicillin-clavulanate, moxifloxacin is more economical for the treatment of CAP.