Cost of ciprofloxacin/dexamethasone vs. amoxicillin/clavulanic acid for the treatment of acute otitis media in tympanostomy tube patients in the US

Summary

A deterministic decision-analytic model estimated the cost effectiveness of two therapeutic alternatives for the treatment of acute otitis media in tympanostomy tube patients (AOMT).

Three tiers of AOMT antibiotic therapy were modelled, with successive tiers representing re-treatment of failures from the preceding tier. First-tier therapy compared ciprofloxacin/dexamethasone (CD) ear drops with oral amoxicillin/clavulanic acid (ACA) using clinical trial data. ACA was used as second-tier therapy for re-treatment of initial CD failures, whilst CD was used to re-treat initial ACA failures. Cefdinir was used as third-tier therapy. Costs were presented from a US payer's perspective. Sensitivity analysis established the robustness of the model.

The expected cost per cure was $219 in the CD pathway vs. $293 in the ACA pathway. Given its effectiveness and side-effect profile, CD was more cost effective than ACA for AOMT therapy. CD dominated ACA despite the higher acquisition cost of CD.

Keywords: :

• antibacterial agents
• anti-infective agents
• anti-inflammatory agents
• costs
• cost analysis
• tympanostomy

Notes