Kragujevac, Serbia – Clostridium difficile (C. difficile) induced colitis is a serious consequence of overzealous utilization of broad spectrum antibiotics, with a rising rate of mortality. The therapeutic approach to C. difficile induced disease includes withdrawal of suspicious precipitating antibiotics while maintaining electrolite balance, and adequate fluid replacement. Recent studies have shown that fidaxomicin can reduce the rate of complications and mortality in patients with colitis induced by Clostridium difficile. Fidaxomicin is a novel macro-cyclic antibiotic which is characterized by low absorption, excellent efficacy, and higher activity in vitro and in vivo against the strain NAP1/BI/027 of C. difficile than that of vancomycin. The introduction of fidaxomicin in clinical practice is limited by its high cost.
In the study, “Cost-Effectiveness Comparison of Fidaxomicin and Vancomycin for Treatment of Clostridium difficile Infection: A Markov Model Based on Data from a South West Balkan Country in Socioeconomic Transition,” researchers from the Department of Pharmacology and Toxicology in the Faculty of Medical Sciences at the University of Kragujevac estimated the cost-effectiveness of fidaxomicine versus vancomycin in patients with colitis induced by C. difficile, who did not respond to oral metronidazole.
The main results of the study indicate that fidaxomicin may be a cost-effective therapy compared with vancomycin; 2.97 million Republic of Serbia dinars (RSD) per life-year saved. However, if the outcome is “number of avoided colectomies,” fidaxomycin is not a cost-effective option compared with vancomycin, as indicated by 10.07 million RSD per one avoided colectomy.
“Treatment of C. difficille infection with fidaxomicin could improve the health status of patients with this infection because it reduces both the mortality rate and the number of colectomies. The sensitivity analyses in this study showed that fidaxomicin would be a more cost-effective therapeutic option for colitis induced by C. difficile if the price of fidaxomicin decreased by 50%, and only when it relates to lives saved as an outcome, and not to total colectomies avoided. Since a further decrease of the acquisition costs of fidaxomicin could be expected only with the introduction of a generic drug in the market (which is possible after 2027) in the next decade, fidaxomicin will be used on small scales in Serbia. The implementation of microeconomic studies is very useful in countries with a recent history of socio-economic transition such as Serbia, since it makes the cost-effective position of new drugs more visible for policy-makers.” says Dr. Slobodan Jankovic, PhD, Professor of Pharmacology and Toxicology at The Faculty of Medical Sciences at University of Kragujevac and a co-author of the study.