Estimating the cost effectiveness of atovaquone versus intravenous pentamidine in the treatment of mild-to-moderate Pneumocystis carinii pneumonia.

Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

Estimating the cost effectiveness of atovaquone versus intravenous pentamidine in the treatment of mild-to-moderate Pneumocystis carinii pneumonia.

Pharmacoeconomics. 1996 Jun;9(6):525-34. Unique Identifier : AIDSLINE HTA/96339251
Zarkin GA; Bala MV; Wood LL; Bennett CL; Simpson K; Dohn MN; Center for Economics Research, Research Triangle Institute,; Research Triangle Park, North Carolina, USA.

Abstract: Pneumocystis carinii pneumonia (PCP) is the most common severe opportunistic infection, and one of the most costly, among people with AIDS. Over 50% of patients experience toxic effects of the major anti-PCP medications- cotrimoxazole (trimethoprim-sulfamethoxazole) and pentamidine. Recently, the US Food and Drug Administration approved a new oral drug therapy, atovaquone, as an alternative to pentamidine for the treatment of people with mild-to-moderate PCP who are intolerant of cotrimoxazole. We developed a decision tree model to estimate the costs and cost effectiveness of atovaquone therapy compared with intravenous pentamidine therapy for cotrimoxazole-intolerant patients with mild-to-moderate PCP. Clinical outcomes were based on data from a phase III trial comparing the 2 medications. Our economic outcomes were based on treatment algorithms derived from discharge data, published reports and the clinical judgement of the co-authors. We estimate the total expected cost of treating a patient for an episode of PCP with atovaquone to be $US3990 compared with $US6545 for pentamidine under our baseline scenario (1995 dollars). Our decision model also provides insight into the large cost-savings benefits of treating mild-to-moderate PCP on an outpatient basis.

Keywords: Antifungal Agents/*ECONOMICS/THERAPEUTIC USE Comparative Study Costs and Cost Analysis Decision Trees Human Injections, Intravenous Monte Carlo Method Naphthoquinones/*ECONOMICS/THERAPEUTIC USE Pentamidine/*ECONOMICS/THERAPEUTIC USE Pneumonia, Pneumocystis carinii/*DRUG THERAPY/*ECONOMICS Support, Non-U.S. Gov't CLINICAL TRIAL JOURNAL ARTICLE
961230
M96C1508

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