{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T03:30:38Z","timestamp":1785295838996,"version":"3.55.0"},"reference-count":50,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Pfizer Investment Co. Ltd.","award":["2021-SKY-A07054-0010"],"award-info":[{"award-number":["2021-SKY-A07054-0010"]}]},{"name":"Zhejiang Pharmaceutical Association Economics and Health Technology Evaluation Special Scientific Research Funding Project","award":["2022-SKY-A07054-0009"],"award-info":[{"award-number":["2022-SKY-A07054-0009"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,8,13]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"\n Objectives<\/jats:title>\n This analysis aims to better reflect the value of new antibiotic treatment strategies, thereby informing clinical antibiotic use, antimicrobial reimbursement and\/or hospital formulary decision-making in China.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n We adapted a published and validated dynamic disease transmission and cost-effectiveness model to evaluate the clinical and economic outcomes of introducing a new antibiotic, ceftazidime\/avibactam (CAZ-AVI) for treating resistant infections in Zhejiang province, China. Outcomes were assessed over a 10-year infectious period and an annual discount rate of 5%. Costs were extracted from the hospital\u2019s Health Information System (HIS) and obtained after data cleaning, aggregation and discounting.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n The Chinese healthcare system perspective.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n \n 10\u2009905 patients in a Chinese tier-3 hospital from 2018 to 2021 with any of the three common infections (complicated intra-abdominal infection (cIAI), hospital-acquired\/ventilator-associated pneumonia (HAP\/VAP) and infections with limited treatment options (LTO)) caused by three common resistant pathogens (\n Escherichia coli, Klebsiella<\/jats:italic>\n spp.\n and Pseudomonas aeruginosa<\/jats:italic>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n (1) Current treatment strategy (piperacillin-tazobactam (pip\/taz) and meropenem); (2) CAZ-AVI at the third line; (3) CAZ-AVI at the second line; (4) CAZ-AVI at the first line; (5) CAZ\/AVI first line, two lines diversified (i.e., equal pip\/taz and CAZ-AVI at the first line; meropenem at the last line) and (6) CAZ\/AVI first line, all-lines diversified.<\/jats:p>\n <\/jats:sec>\n \n Primary outcome measures<\/jats:title>\n Quality-adjusted life years (QALYs) lost, hospitalisation costs and incremental net monetary benefit (INMB) were used to assess cost-effectiveness.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Over 10 years, the introduction of CAZ-AVI to the current treatment strategy led to lower hospitalisation costs and more QALYs across all five treatment strategies, with between 68\u2009284 and 78\u2009571 QALYs gained whilst saving up to US$236.37 for each additional QALY gained. The INMB of introducing CAZ-AVI is estimated up to US$3 550 811 878.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Introducing CAZ-AVI had a positive impact on clinical and economic outcomes for treating antimicrobial resistance, and diversifying the antibiotics use early in the treatment might yield the best benefits.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-086039","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T22:41:30Z","timestamp":1724971290000},"page":"e086039","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Estimating the value of new antibiotic treatment strategies in Zhejiang province, China: cost-effectiveness analysis based on a validated dynamic model"],"prefix":"10.1136","volume":"14","author":[{"given":"Wenqianzi","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Science and Education of the Fourth Affiliated Hospital and School of Public Health, Center for Health Policy Studies, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Zhen","sequence":"additional","affiliation":[{"name":"Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (NHC Key Laboratory of Health Economics and Policy Research), Shandong University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueshan","family":"Sun","sequence":"additional","affiliation":[{"name":"School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shikha Upadhyaya","family":"Khatiwada","sequence":"additional","affiliation":[{"name":"Department of Science and Education of the Fourth Affiliated Hospital and School of Public Health, Center for Health Policy Studies, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danhong","family":"Yang","sequence":"additional","affiliation":[{"name":"Zhejiang Provincial People\u2019s Hospital, People\u2019s Hospital of Hangzhou Medical College, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixi","family":"Chen","sequence":"additional","affiliation":[{"name":"Pfizer Investment Co. Ltd, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Dong","sequence":"additional","affiliation":[{"name":"Pfizer Investment Co. Ltd, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amer","family":"Al-Taie","sequence":"additional","affiliation":[{"name":"Pfizer R&D UK Limited, Tadworth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Gordon","sequence":"additional","affiliation":[{"name":"Health Economics and Outcomes Research Ltd, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5064-7297","authenticated-orcid":false,"given":"Hengjin","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Science and Education of the Fourth Affiliated Hospital and School of Public Health, Center for Health Policy Studies, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"2025121404082881000_14.8.e086039.1","unstructured":"World Health Organization . 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