1332. Cost-Effectiveness of an Outpatient Parenteral Antimicrobial Therapy (OPAT) Care Coordination Service
Session: Poster Abstract Session: Clinical Practice Issues
Friday, October 28, 2016
Room: Poster Hall
Posters
  • Poster IDWeek 2016.pdf (720.6 kB)
  • Background: Patients needing long-term parenteral antimicrobial therapy are often discharged from the hospital to complete this treatment at home. A 2013 paper showed the effect of a pharmacist-led care coordination service, the infectious diseases transitions service (IDTS) on improving processes of care and complications among patients on outpatient parenteral antimicrobial therapy (OPAT).1 However, little is known about the cost-effectiveness of the resource-intensive IDTS compared to the standard of care (no care-coordination service). The objective of this study was to assess the cost-effectiveness of the infectious disease transition service compared to standard of care for patients discharged on OPAT.

    Methods: Data regarding patient outcomes was abstracted from prior work.1 The main cost of the intervention was the cost for an 0.8 full-time equivalent pharmacist. A Markov Model for cost-effectiveness analysis was carried out over a twelve-month time horizon from the societal perspective, which includes costs to the patient and to the healthcare system. We used 1,000 Monte-Carlo simulations to carry out probabilistic sensitivity analysis.

    Results:

    Compared to standard of care (average cost per OPAT patient, $56.257.65 and 5.716 life-years by the end of the year), the IDTS improved survival at a lower cost (average cost per OPAT patient, $47,191.96 and 5.734 life-years). This led to a deterministic incremental cost-effectiveness ratio (ICER) of -$498,410.75 per life-year gained suggesting that IDTS intervention dominates standard of care approach. This compares well with the widely-accepted willingness to pay threshold of $50,000 per life-year gained. Based on this, the probabilistic sensitivity analysis showed that IDTS compared to standard of care was cost-effective in 71% of Monte-Carlo simulations.

    Conclusion: Our analyses showed that IDTS intervention is cost-effective compared to the standard of care based a willingness to pay threshold of $50,000. It improved survival at a lower cost. Healthcare systems and payers should consider these results when deciding whether to fund OPAT care coordination services.

    1Keller SC, Ciuffetelli D, Bilker W, et al. The Impact of an Infectious Diseases Transition Service on the Care of Outpatients on Parenteral Antimicrobial Therapy. J Pharm Technol 2013;29:205-14.

    Aleksandra Mihailovic, ScM1, Zhengchun Jiang, BS2, Shanshan Wang, BS2, Komal Kumar, BS2, Daniel Timko, PharmD, BCPS, AQID3 and Sara Keller, MD, MPH, MSHP4, (1)Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, (2)Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (3)Pharmacy, Hospital of the University of Pennsylvania, Philadelphia, PA, (4)Department of Medicine, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, MD

    Disclosures:

    A. Mihailovic, None

    Z. Jiang, None

    S. Wang, None

    K. Kumar, None

    D. Timko, None

    S. Keller, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.