Three cephalosporin antibiotics in the treatment of lower respiratory tract infections: Cost-effectiveness analysis.
Cost: 75.6X2 + 6.26X2X8 + 18.7X2X8 = 2818.56 yuan, the cost of Group C (45.6X3 + 6.26) X2X8 + 18.7X2X8 = 2588.16 yuan.
2.2 Clinical efficacy and adverse reactions: The total effective rate of Group A was 77.78%, Group B's total effective rate was 91.11%, and Group C's total effective rate was 90.48%. There were no significant differences in efficacy between groups (P>0.05).
Table 1 shows that there were four cases of adverse reactions in Group A, three cases in Group B, and one case in Group C. The incidence rates of adverse reactions in the three groups were 8.89%, 6.67%, and 9.52%, respectively, with no significant difference among the three groups (P>0.05). The main adverse events were rash and gastrointestinal reactions, with one case of mild alanine aminotransferase increase and one case of mild serum creatinine increase, both of which normalized after stopping the medication and did not affect the treatment.
Table 1 also displays the clinical efficacy of the three groups.
2.3 Cost-effectiveness analysis: Cost-effectiveness analysis aims to find the most economical treatment options that achieve the same therapeutic effect, i.e., finding the best combination of cost and effectiveness. The cost-effectiveness ratio (C/E) is organically linked, representing the cost per unit of effect. Usually, when costs increase, the corresponding effect increases, but they are not directly proportional. When the cost increases to a certain extent, the increase in effect will gradually decrease or stop increasing altogether. An increase in the cost-effectiveness ratio (AC/AE) indicates that the smaller the ratio, the less additional cost required for each additional unit of effect, and the greater the significance of the program implementation. In this study, the cost-effectiveness analysis of the three groups treating lower respiratory tract infections is shown in Table 2. From Table 2, it can be seen that Group A's cost-effectiveness ratio was significantly lower than Groups B and C, making it the best option from an economic perspective.
2.4 Sensitivity analysis: Parameters in drug economics often carry uncertainty, so varying these parameters is necessary to examine the accuracy of the results, i.e., sensitivity analysis. Assuming other costs remain unchanged and drug prices decrease by 15%, the results are consistent with previous findings as shown in Table 3.
Table 3 presents the sensitivity analysis of the three therapy programs.
Discussion: Ceftriaxone and ceftizoxime are third-generation cephalosporins with broad-spectrum antibacterial effects. Ceftriaxone has been clinically used for many years and is safe and reliable, though it has a higher resistance rate. Ceftizoxime is a newly developed semi-synthetic cephalosporin with better beta-lactamase stability than ceftriaxone. Cefepime is a fourth-generation cephalosporin, offering a broader antimicrobial spectrum and stronger antimicrobial activity compared to third-generation cephalosporins, with even better beta-lactamase stability. However, the latter two are more expensive, limiting their use to some extent. From a pharmacoeconomic perspective, developing a rational drug treatment plan is very important as it can save a lot of medical expenses. Tables 1 and 2 show that although ceftriaxone's efficiency is lower than cefepime and ceftizoxime, the difference is not statistically significant. Its unit cost-effectiveness is significantly lower than the latter two, and it only requires daily medication, making it the best option. The sensitivity analysis in Table 3 also verifies the reliability of the results.
However, the affordability of healthcare requirements depends on the incremental cost ratio. Option B could be considered an appropriate program, while Option C might not be ideal. Factors such as the origin of the drugs, the duration of medication, the determination of efficacy standards, and the regional scope of the study may introduce deviations in statistical results, thereby impacting the cost-effectiveness analysis results. Therefore, further clinical information is needed to confirm the analysis results.