{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T18:34:28Z","timestamp":1770489268711,"version":"3.49.0"},"reference-count":35,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,11,27]],"date-time":"2017-11-27T00:00:00Z","timestamp":1511740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004334","name":"Merck","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The reduction in recurrent <jats:italic>Clostridium difficile\u2013<\/jats:italic>associated diarrhea (CDAD) with fidaxomicin therapy may reduce hospital readmissions and lead to lower overall CDAD costs. However, studies assessing the cost\u2010effectiveness of fidaxomicin as first\u2010line therapy from the U.S. hospital perspective are lacking. This study evaluated the costs associated with utilizing fidaxomicin or vancomycin as a first\u2010line therapy for CDAD in specific patient populations from a U.S. hospital perspective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A decision\u2010analytic model was developed to estimate total costs (hospitalization and drug costs) associated with using fidaxomicin or vancomycin as first\u2010line therapy for a first episode and up to two recurrences of CDAD in five patient populations: general population, elderly, patients receiving concomitant antibiotics, and patients with renal impairment or cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total cost of CDAD treatment using fidaxomicin first line in the general population was $14,442 per patient versus $14,179 per patient with vancomycin first line. In subgroup analyses, fidaxomicin use resulted in total hospital cost savings of $616 per patient in patients with cancer and $312 in patients with concomitant antibiotic use; vancomycin use was associated with total hospital cost savings of $243 per patient in the elderly and $371 in patients with renal impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Fidaxomicin as first\u2010line CDAD therapy is associated with similar total costs as compounded vancomycin oral solution in the general population. In elderly and renally impaired patients, slight increases in hospital cost were observed with fidaxomicin therapy, and in patients with cancer or concomitant antibiotic use, hospital cost savings were observed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2049","type":"journal-article","created":{"date-parts":[[2017,10,17]],"date-time":"2017-10-17T05:16:41Z","timestamp":1508217401000},"page":"1489-1497","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Fidaxomicin versus Vancomycin as a First\u2010Line Treatment for <i>Clostridium difficile<\/i>\u2013Associated Diarrhea in Specific Patient Populations: A Pharmacoeconomic Evaluation"],"prefix":"10.1002","volume":"37","author":[{"given":"Kelly R.","family":"Reveles","sequence":"first","affiliation":[{"name":"College of Pharmacy The University of Texas at Austin Austin Texas"},{"name":"Pharmacotherapy Education and Research Center University of Texas Health Science Center at San Antonio San Antonio Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Backo","sequence":"additional","affiliation":[{"name":"Merck and Co., Inc. 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