Cost-effectiveness of omadacycline versus moxifloxacin as the initial treatment for community-acquired bacterial pneumonia in China.

INTRODUCTION

Clinical studies have shown that omadacycline is non-inferior to moxifloxacin, a widely used respiratory fluoroquinolone, in terms of efficacy. However, the higher acquisition cost of omadacycline raises questions regarding its economic value, particularly in resource-limited healthcare systems such as China.

AIM: This study evaluated the cost-effectiveness of omadacycline versus moxifloxacin as initial treatment for CABP in China.

METHOD: A decision-tree model was constructed using TreeAge Pro 2020 to assess sequential intravenous (IV)-to-oral omadacycline versus moxifloxacin in adult patients with non-severe CABP. Parameter values were obtained from published literature, public databases, and medical service pricing datas. Incremental cost-effectiveness ratios (ICERs) were calculated, and sensitivity analyses were performed to assess model robustness. A regimen was considered cost-effective if the ICER fell below the willingness-to-pay (WTP) threshold of $19,012 per quality-adjusted life year (QALY).

RESULTS

In the base-case analysis, omadacycline provided an additional 0.004 QALY at an incremental cost of $597.8, resulting in an ICER of $148,700/QALY-substantially exceeding the $19,012 threshold. The cost of oral and IV omadacycline were the most influential parameters. Omadacycline was optimal in 7.6% of 10,000 Monte Carlo simulations at the $19,012/QALY threshold. Province-specific WTP thresholds showed cost-effectiveness probabilities ranging from 1.1% (Gansu) to 16.2% (Beijing).

CONCLUSION

Omadacycline is not cost-effective compared to moxifloxacin as the initial treatment for CABP in China, unless significant price reductions are achieved.