Economic impact of individualized antimicrobial dose optimization in the critically ill patient in Spain
ObjectiveTo estimate the economic impact of individualized dose optimization guided by antimicrobial therapeutic drug monitoring (TDM) in Spain, compared to no monitoring.MethodsA cost analysis of antibiotic treatment of critically ill patients, with and without TDM, was performed using a probabilis...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2025.1506109/full |
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| author | Santiago Grau Santiago Grau Sonia Luque Olivia Ferrandez Olivia Ferrandez Adela Benitez Cano Darío Rubio-Rodríguez Carlos Rubio-Terrés |
| author_facet | Santiago Grau Santiago Grau Sonia Luque Olivia Ferrandez Olivia Ferrandez Adela Benitez Cano Darío Rubio-Rodríguez Carlos Rubio-Terrés |
| author_sort | Santiago Grau |
| collection | DOAJ |
| description | ObjectiveTo estimate the economic impact of individualized dose optimization guided by antimicrobial therapeutic drug monitoring (TDM) in Spain, compared to no monitoring.MethodsA cost analysis of antibiotic treatment of critically ill patients, with and without TDM, was performed using a probabilistic Markov model (with second-order Monte Carlo simulations). Three scenarios were analyzed based on three published meta-analyses (Analysis 1: Pai Mangalore, 2022; Analysis 2: Sanz-Codina, 2023; Analysis 3: Takahashi, 2023).ResultsTDM, compared to the no-TDM option, generated according to the meta-analysis, a per patient expenditure of €195 (95%CI €194; €197) in analysis 1 or savings of -€301 (95%CI -€300; -€304) and -€685 (95%CI -€685; -€684) in analyses 2 and 3. The probability of TDM (vs. no-TDM) generating savings would be 39.4%, 63.5% and 79.7% in analyses 1, 2 and 3, respectively. This discrepancy in the results is due to methodological differences, in particular in the cure rate with TDM (vs. no-TDM) obtained in the meta-analyses: 12.2%, 16.6% and 16.0% more in analyses 1, 2 and 3, respectively.ConclusionIn critically ill patients undergoing antimicrobial therapy TDM, there is an increased likelihood of cure. However, the currently available data are not conclusive on the economic impact of such a therapeutic effect. |
| format | Article |
| id | doaj-art-f954294f351a4c00a2e849953fe7831c |
| institution | DOAJ |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj-art-f954294f351a4c00a2e849953fe7831c2025-08-20T03:11:22ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-02-011610.3389/fphar.2025.15061091506109Economic impact of individualized antimicrobial dose optimization in the critically ill patient in SpainSantiago Grau0Santiago Grau1Sonia Luque2Olivia Ferrandez3Olivia Ferrandez4Adela Benitez Cano5Darío Rubio-Rodríguez6Carlos Rubio-Terrés7Hospital del Mar, Parc de Salut Mar, Barcelona, SpainUniversitat Pompeu Fabra, Barcelona, SpainHospital del Mar, Parc de Salut Mar, Barcelona, SpainHospital del Mar, Parc de Salut Mar, Barcelona, SpainUniversitat Pompeu Fabra, Barcelona, SpainHospital del Mar, Parc de Salut Mar, Barcelona, SpainHealth Value, Madrid, SpainHealth Value, Madrid, SpainObjectiveTo estimate the economic impact of individualized dose optimization guided by antimicrobial therapeutic drug monitoring (TDM) in Spain, compared to no monitoring.MethodsA cost analysis of antibiotic treatment of critically ill patients, with and without TDM, was performed using a probabilistic Markov model (with second-order Monte Carlo simulations). Three scenarios were analyzed based on three published meta-analyses (Analysis 1: Pai Mangalore, 2022; Analysis 2: Sanz-Codina, 2023; Analysis 3: Takahashi, 2023).ResultsTDM, compared to the no-TDM option, generated according to the meta-analysis, a per patient expenditure of €195 (95%CI €194; €197) in analysis 1 or savings of -€301 (95%CI -€300; -€304) and -€685 (95%CI -€685; -€684) in analyses 2 and 3. The probability of TDM (vs. no-TDM) generating savings would be 39.4%, 63.5% and 79.7% in analyses 1, 2 and 3, respectively. This discrepancy in the results is due to methodological differences, in particular in the cure rate with TDM (vs. no-TDM) obtained in the meta-analyses: 12.2%, 16.6% and 16.0% more in analyses 1, 2 and 3, respectively.ConclusionIn critically ill patients undergoing antimicrobial therapy TDM, there is an increased likelihood of cure. However, the currently available data are not conclusive on the economic impact of such a therapeutic effect.https://www.frontiersin.org/articles/10.3389/fphar.2025.1506109/fulltherapeutic drug monitoringdose optimizationantimicrobialscritical ill patienteconomic impact |
| spellingShingle | Santiago Grau Santiago Grau Sonia Luque Olivia Ferrandez Olivia Ferrandez Adela Benitez Cano Darío Rubio-Rodríguez Carlos Rubio-Terrés Economic impact of individualized antimicrobial dose optimization in the critically ill patient in Spain Frontiers in Pharmacology therapeutic drug monitoring dose optimization antimicrobials critical ill patient economic impact |
| title | Economic impact of individualized antimicrobial dose optimization in the critically ill patient in Spain |
| title_full | Economic impact of individualized antimicrobial dose optimization in the critically ill patient in Spain |
| title_fullStr | Economic impact of individualized antimicrobial dose optimization in the critically ill patient in Spain |
| title_full_unstemmed | Economic impact of individualized antimicrobial dose optimization in the critically ill patient in Spain |
| title_short | Economic impact of individualized antimicrobial dose optimization in the critically ill patient in Spain |
| title_sort | economic impact of individualized antimicrobial dose optimization in the critically ill patient in spain |
| topic | therapeutic drug monitoring dose optimization antimicrobials critical ill patient economic impact |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2025.1506109/full |
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