Telithromycin (Ketek®)in lower respiratory tract infections: economic aspects

Abstract

The aim of the paper is to compare Italian healthcare-related costs and effectiveness of 7- and 5- day course with telitromicin (Ketek®) 800 mg od vs. 10-day clarithromycin 500 mg bid in patients with Community-acquired pneumonia (CAP) and Acute exacerbations of chronic bronchitis (AECB), respectively. Clinical as well as healthcare-related resource consumption data were collected from two Medline indexed articles reporting results of three international trials. Since differences in effectiveness among the compared antibiotic courses did not reach statistical significance, two cost-minimization analyses were performed from Italian National Healthcare Service (INHS) perspective. CAP and AECB-related hospitalizations were evaluated according to INHS DRGs tariffs, whereas drugs were costed according to Italian National Therapeutic Formulary. Costs are expressed in euros 2005. When compared to 10-day clarithromycin 500 mg bid, savings related to 7-day telitromicin 800 mg od approach 102,10 euros per CAP patient (IC 95: -177,89 euros − -26,31 euros; p<0,01). In comparison with 10-day clarithromycin 500 mg bid, 5-day telitromicin 800 mg od allows saving for 79,78 euros per AECB patient (IC 95: -125,42 euros  -34,15 euros; p<0,001). Sensitivity analyses confirmed the robustness of basecase results. Telitromicin induces savings related to both antibiotic course and hospitalization. Results should be confirmed via empirical health economic studies carried out in Italy.