Cost-effectiveness Analysis Of Linezolid And Vancomycin In The Tratment Of HAP Caused By MRSA Based On The Decision Tree Model

Objective: To evaluate the cost-effectiveness of linezolid and vancomycin in the treatment of hospital-acquired pneumonia(HAP)caused by Methicillin-resistant Staphylococcus(MRSA)by employing the decision tree model,which will provide a theoretical basis for the rational drug use in clinical.Methods:1.The data were collected from the Embase,Pubmed,Cochrane library,CNKI,VIP,Wanfang and so on,screened and evaluated the literature,finally included high-quality randomized controlled trials of linezolid and vancomycin for the treatment of MRSA-infected HAP.2.Based on the high-quality randomized controlled trial of linezolid in the treatment of HAP caused by MRSA,combined with the domestic clinical parameters,medical costs and expert opinion,the cost-effectiveness analysis of linezolid and vancomycin in the treatment of HAP caused by MRSA was evaluated by the application of Tree Age Pro 2011 software.Meanwhile,the tornado diagram was emlpoyed to analyze the sensitivity of each factor.Subsequently,the factors which have a great influence were further evaluated by the one-way,two-way and probabilistic sensitivity analyse.Results:1.The model allowed us to calculate the total base case inpatient costs as ￥15183.60(linezolid)and ￥14147.97(vancomycin).The incremental cost-effectiveness ratio favored vancomycin(versus linezolid),with lower costs(￥1035.63 less)and lower efficacy(3%,60% vs 63%).The incremental cost-effectiveness ratio(ICER)for linezolid to vancomycin was ￥34521,Sensitivity analysis confirmed that this result was reliable.2.Under the current Yunnan’s GDP level,the incremental cost-effectiveness ratio(ICER)of linezolid group versus vancomycin group is more than 1 times the Per capita GDP(Yunnan),and less than 3 times the Per capita GDP(Yunnan).Conclusion:1.Vancomycin compared to linezolid appears to be more cost-effective in the HAP treatment which caused by MRSA.2.In the perspective of pharmacoeconomics,give linezolid priority in the treatment of HAP caused by MRSA under the current Yunnan GDP level is acceptable.