Infection Control & Hospital Epidemiology


Table 2. Model Inputs Parameter


Utilities Utility of active CDI while hospitalized Utility of active CDI, not hospitalized Utility postcolectomy Utility healthy (65 y old)


Drug Cost, US$ Bezlotoxumab cost per dose


Vancomycin (inpatient) cost per dose Vancomycin (outpatient) cost per dose Fidaxomicin cost per dose


Other Costs, US$ Cost per hospitalization Cost per doctors visit Cost per colectomy


Cost for fecal transplant via colonoscopy


Clinical probabilities, P Hospitalization for Clostridium difficile Vancomycin cure Fidaxomicin cure


Bezlotoxumab + vancomycin cure Vancomycin recurrence Fidaxomicin recurrence


Bezlotoxumab + vancomycin recurrence Vancomycin taper cure


Vancomycin taper recurrence Receiving colectomy Colectomy survival


Fecal transplant survival Survival at 1 y


927


Base Case 0.60


0.782 0.536 0.88


4,560 1.95


42.99 220.90


17,522 106.45 42,062 1,259


.341 .844 .841 .800 .325 .203 .165 .31 .66


.0111 .508 .90


.924


Range


0.505–0.695 0.628–0.936 0.382–0.69 0.84–0.92


2,280–6,840 1.54–2.41


31.30–57.70 110.45–331.34


15,665–19,377 84.83–131.22 31,547–52,577 944–1,574


.296–.388 .753–.912 .748–.910 .770–.828 .224–.439 .12–.308 .134–.208 .15–.48 .49–.83


.0101–.0122 .435–.58 .875–.925 .891–.949


Standard Deviation


0.156 0.154 0.154 0.02


1,140 0.22 6.60


55.23


925 8.06


5,258 157.50


.0225 .040


.0467 .014 .054


.0415 .0185 .085 .085


.00055 .154


.0125 .0145


Distribution


Beta Beta Beta Beta


Gamma Gamma Gamma Gamma


Gamma Gamma Gamma Gamma


Beta Beta Beta Beta Beta Beta Beta Beta Beta Beta Beta Beta Beta


Reference


12 12 26 27


29 29 29 29


13 30 13 15


10 22 22 11 22 22 11


24, 25 24, 25 10 23 24 10


Table 3. Base Case Results: Incremental Cost-Effectiveness Ratio Treatment


Vancomycin Fidaxomicin


Bezlotoxumab + vancomycin


15,692 17,047 18,475


NOTE. ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life years.


Total Cost per Patient, 2017 US$


ICER


Total QALYs per Patient 0.8019 0.8046 0.8039


(cost per additional QALY gained) 500,975 Abs. dominated


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