{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:42:53Z","timestamp":1790127773380,"version":"4.0.1"},"reference-count":32,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T00:00:00Z","timestamp":1609200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hosp Pharm"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:p>Introduction: Carbapenem-resistant organisms (CROs) present a serious public health problem. Limited treatment options has led to increased use of colistin and polymyxin. Since 2014, the US Food and Drug Administration approved 4 new beta-lactam beta-lactamase inhibitor (BLBLI) combination antibiotics with activity against CROs. These new antibiotics have been shown to be more effective and less toxic than colistin and polymyxin but are considerably more expensive. This study evaluated the cost-effectiveness of the new BLBLIs versus colistin-based therapy for the treatment of CROs. Methods: A decision-tree microsimulation model was used to evaluate the cost effectiveness of the new BLBLIs versus colistin-based therapy for the treatment of CROs. Treatment groups differed in risk of mortality and risk of an acute kidney injury (AKI). The relative risk of mortality was determined by creating a meta-analysis comparing new BLBLIs to colistin. Cost inputs included medication costs and the cost to treat an AKI. The primary outcomes include quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER). Model inputs included: clinical outcomes and adverse events (30-day mortality and AKI); cost of treatment and adverse drug events; and health utilities. A 3% discount was applied for outcomes. A lifetime horizon was used from the perspective of the US healthcare system with a willingness-to-pay (WTP) threshold of $100\u2009000. A sensitivity analysis was done to incorporate uncertainty. Results: The meta-analysis found the treatment with a new BLBLI was associated with a 50% decrease in the relative risk of 30-day mortality compared to colistin (RR 0.47, 95% CI 0.25-0.88). Treatment with a new BLBLI cost $16\u2009200 and produced 11.5 QALYs, on average. The average colistin based regimen cost $3500 and produced 8.3 QALYs. The new BLBLIs were determined to be cost-effective with an ICER of $3900\u2009per QALY gained. Treatment with a BLBLI remained cost-effective under all uncertainty scenarios tested. Conclusion: New BLBLIs are cost-effective compared to colistin for the treatment of CROs and are associated with improved mortality and fewer AKI events. The use of colistin should be reserved for cases where new BLBLIs are not available or there is documented resistance to these new antibiotics.<\/jats:p>","DOI":"10.1177\/0018578720985436","type":"journal-article","created":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T05:06:39Z","timestamp":1609218399000},"page":"93-100","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Cost-Effectiveness Analysis of New Beta-Lactam Beta-Lactamase Inhibitor Antibiotics Versus Colistin for the Treatment of Carbapenem-Resistant Infections"],"prefix":"10.1177","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4144-7250","authenticated-orcid":false,"given":"Monica L.","family":"Bianchini","sequence":"first","affiliation":[{"name":"University of Colorado Anschutz Medical Campus, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan N.","family":"Jeffres","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan D.","family":"Campbell","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,12,29]]},"reference":[{"key":"bibr1-0018578720985436","volume-title":"Antibiotic Resistance Threats in the United States","author":"CDC","year":"2019"},{"key":"bibr2-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30753-3"},{"key":"bibr3-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00115-20"},{"key":"bibr4-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.12801"},{"key":"bibr5-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02634-15"},{"key":"bibr6-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1918"},{"key":"bibr7-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00883-17"},{"key":"bibr8-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix783"},{"key":"bibr9-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-018-0214-1"},{"key":"bibr10-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4409-1"},{"key":"bibr11-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz530"},{"key":"bibr12-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2209"},{"key":"bibr13-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir073"},{"key":"bibr14-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky027"},{"key":"bibr15-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1086\/649554"},{"key":"bibr16-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw353"},{"key":"bibr17-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz344"},{"key":"bibr18-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1159\/000475607"},{"key":"bibr19-0018578720985436","unstructured":"Review Manager (RevMan)\n                      [computer program]. Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration; 2014."},{"key":"bibr20-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2018.11.008"},{"key":"bibr21-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-017-2408-7"},{"key":"bibr22-0018578720985436","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02570310"},{"key":"bibr23-0018578720985436","unstructured":"RED BOOK Online. IBM Micromedex [database online]. Truven Health Analytics\/IBM Watson Health. 2020. Accessed October 20, 2019. https:\/\/www.micromedexsolutions.com"},{"key":"bibr24-0018578720985436","unstructured":"ICER. 2020-2023 Value Assessment Framework. Institute for Clinical and Economic Review. Published January 31, 2020. Updated October 23, 2020. Accessed November 18, 2020. https:\/\/icer-review.org\/wp-content\/uploads\/2020\/10\/ICER_2020_2023_VAF_102220.pdf"},{"key":"bibr25-0018578720985436","first-page":"1","volume":"328","author":"Murphy SL","year":"2018","journal-title":"INCHS Data Brief"},{"key":"bibr26-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-019-2314-z"},{"key":"bibr27-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofv050"},{"key":"bibr28-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2019.06.008"},{"key":"bibr29-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00897-19"},{"key":"bibr30-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2019.06.009"},{"key":"bibr31-0018578720985436","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2016.09.003"},{"key":"bibr32-0018578720985436","unstructured":"American Hospital Association, Federation of American Hospitals, American Society of Health-System Pharmacists. Recent Trends in Hospital Drug Spending and Manufacturer Shortages. Final Report; 2019."}],"container-title":["Hospital Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0018578720985436","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0018578720985436","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0018578720985436","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:39:29Z","timestamp":1777451969000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0018578720985436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,29]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1177\/0018578720985436"],"URL":"https:\/\/doi.org\/10.1177\/0018578720985436","relation":{},"ISSN":["0018-5787","1945-1253"],"issn-type":[{"value":"0018-5787","type":"print"},{"value":"1945-1253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,29]]}}}