Format

Send to

Choose Destination
Int J Tuberc Lung Dis. 2009 Aug;13(8):945-54.

Cost and clinical consequence of antibiotic non-adherence in acute exacerbations of chronic bronchitis.

Author information

1
United BioSource Corporation, Bethesda, Maryland, USA.

Abstract

OBJECTIVE:

To quantify the impact of non-adherence on the clinical effectiveness of antibiotics for acute exacerbations of chronic bronchitis (AECB) and to estimate the economic consequences for Spain, Italy and the United States.

METHODS:

Standard systematic reviewing procedures were followed to identify randomised controlled clinical trials of antibiotic treatment for acute respiratory tract infection for which adherence was reported. A decision-analytic model was then constructed to evaluate the impact of non-adherence to antibiotic treatment on clinical effectiveness and costs per AECB episode. The model compared the total treatment costs, cure rates and incremental costs per cure for a poor compliance group (PCG) against a good compliance group (GCG). Clinical and resource use estimates were from the published literature and physician surveys.

RESULTS:

Twenty-five articles met the criteria of the systematic review, although only one reported treatment success by adherence status. The relative risk of clinical effectiveness if non-adherent was 0.75 (95%CI 0.73-0.78). Based on this single study, the model predicted that 16-29% more patients would be cured in the GCG vs. the PCG, and payers would save up to euro122, euro179 and US$141 per AECB episode in Spain, Italy and the United States, respectively.

CONCLUSIONS:

Non-adherence to antibiotics for AECB may have an impact on clinical effectiveness, which is associated with increased costs.

PMID:
19723373
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Ingenta plc
Loading ...
Support Center