Economic evaluation of ceftibuten in the treatment of uncomplicated urinary tract infections in adult Mexican patients

BackgroundUrinary tract infections are a leading cause of medical consultations in Mexico and the growth of antimicrobial resistance results in increased morbidity and rising costs.AimTo make an economic evaluation of ceftibuten as treatment for uncomplicated urinary tract infections in adults, from the perspective of the Mexican private health system.MethodsA cohort-based decision-making model was developed to compare ceftibuten with TMP-SMX, ciprofloxacin, and cefalexin. Effectiveness was measured using local susceptibility rates of Escherichia coli. Costs were obtained from official market value data and converted to 2014 USD values. Incremental analysis was employed to determine if ceftibuten was a worthwhile investment on the part of the private health system in Mexico.ResultsThe total expected cost per patient for ciprofloxacin was $116 USD and the corresponding costs for TMP/SMX and cefalexin were $92.40 USD and $74.80 USD, respectively. Ceftibuten had a lower expected cost ($34.50 USD) and a higher percentage of therapeutic success (99.4%), compared with ciprofloxacin 21%, cefalexin 41%, and TMP/SMX 31.7%.ConclusionsEven though ceftibuten has a higher market price than other antimicrobials in Mexico, it can represent possible savings by avoiding the costs associated with undesirable results due to antimicrobial resistance to E. coli.

ResumenAntecedentesLas infecciones urinarias son una causa principal de consultas médicas en México. La resistencia antimicrobiana creciente incrementa la morbilidad y los costos.ObjetivoRealizar una evaluación económica del ceftibuteno como tratamiento de infecciones urinarias no complicadas en adultos desde la perspectiva del sistema de salud privado en México.Material y métodosCohorte de modelo de decisión comparando ceftibuteno con TMP-SMX, ciprofloxacina y cefalexina. Medición de efectividad usando rangos de susceptibilidad locales para Escherichia coli. Costos obtenidos de datos oficiales de valores de mercado y convertidos en valores en dólares americanos en 2014. Análisis incremental utilizado para determinar la inversión en ceftibuteno desde la perspectiva del sistema de salud privado en México.ResultadosLos costos totales por paciente con ciprofloxacina fueron US$116 mientras que los costos correspondientes con TMP/SMX y cefalexina fueron US$92.4 y US$74.8 respectivamente. El ceftibuteno resultó con valor más bajo (US$34.50) y un alto porcentaje de éxito terapéutico (99.4%) comparado con ciprofloxacina (21%); cefalexina (41%) y TMP/SMX (31.7%).ConclusionesEl ceftibuteno aun teniendo el valor más alto por unidad en México provee de posibilidad de obtener ahorros evitando costos asociados a resultados indeseables por la resistencia antimicrobiana de Escherichia coli.