PharmacoEconomics

, Volume 10, Issue 3, pp 239–250 | Cite as

Cost Saving of 5-day Therapy with Cefpodoxime Proxetil versus Standard 10-day β-Lactam Therapy for Recurrent Pharyngotonsillitis in Adults

A Prospective General Practice Study
  • Alain Pelc
  • Henri Portier
  • Pierre Gehanno
  • Sylvie Fiessinger
  • Françoise Ichou
Original Research Article Cefpodoxime Proxetil in Tonsillitis

Summary

A prospective economic evaluation was undertaken as part of a randomised clinical trial conducted in French general practice. Its aim was to compare the costs and therapeutic outcomes of a 5-day course of cefpodoxime proxetil 100mg twice daily with 10-day courses of phenoxymethylpenicillin (penicillin V) 1 MIU 3 times daily and amoxicillin-clavulanic acid 500/l25mg 3 times daily for the treatment of recurrent pharyngotonsillitis in 575 adults.

Over the 6-month study period, the total cost to society per patient treated with cefpodoxime proxetil was 123 French francs (FF; 1993 values) lower than that for patients treated with phenoxymethylpenicillin and FF227 lower than that for patients treated with amoxicillin-clavulanic acido This cost saving was primarily attributable to a lower initial drug acquisition cost, and a reduction in the cost associated with lost productivity and general practitioner consultations. Furthermore, as a consequence of a lower relapse rate, the cost-saving ratio for cefpodoxime proxetil, expressed as FF per month free of recurrence, was FF50 less than for phenoxymethylpenicillin and FF60 less than for amoxicillin-clavulanic acido

Thus, a 5-day course of cefpodoxime proxetil is likely to be less costly for treatment of pharyngotonsillitis in the general practice setting than standard IO-day courses of phenoxymethylpenicillin and amoxicillin-clavulanic acido

Keywords

Adis International Limited Tonsillitis Cefpodoxime Drug Acquisition Cost Penicillin Versus 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Pichichero ME. Group A streptococcal tonsillopharyngitis: cost–effective diagnosis and treatment. Ann Emerg Med 1995; 25: 390–403PubMedCrossRefGoogle Scholar
  2. 2.
    ReynoIds JEF, editor. MartindaIe: the extra pharmacopoeia. 30th rev. London: The Pharmaceutical Press, 1993Google Scholar
  3. 3.
    Schwartz R, Wientzen R, Pedaeira F, et al. Penicillin V for group A streptococcal pharyngotonsillitis. JAMA 1981; 246: 1790–5PubMedCrossRefGoogle Scholar
  4. 4.
    Gerber MA, Randolph MF, Chanatry J, et al. Five vs ten days of penicillin V therapy for streptococcal pharyngitis. Am JDis Child 1987; 141: 224–7Google Scholar
  5. 5.
    Pichichero ME. Controversies in the treatment of streptococcal pharyngitis. Am Fam Physician 1990; 42: 1567–76PubMedGoogle Scholar
  6. 6.
    Kaplan EL, Johnson DR. Eradication ofgroup Astreptococci from the upper respiratory tract by amoxicillin with clavulanate afteroral penicillin V treatment failure. J Pediatr 1988; 113: 400–3PubMedCrossRefGoogle Scholar
  7. 7.
    Brook I. Treatment of patients with acute recurrent tonsillitis due to group A beta–hemoIytic streptococci: a prospectiverandomised study comparing penicillin and amoxicillinlclavulanate potassium. J Antimicrob Chemother 1989; 24: 227–33PubMedCrossRefGoogle Scholar
  8. 8.
    Frampton JE, Brogden RN, Langtry HD, et al. Cefpodoxime proxetil: a review of its antibacterial activity, pharmacokineticproperties and therapeutic potential. Drugs 1992; 44: 889–917PubMedCrossRefGoogle Scholar
  9. 9.
    Brown RJ, Batts DH, Hughes GS, et al. Comparison of oral cefpodoxime proxetil and penicillin V potassium in the treatmentof Group A streptococcal pharyngitis/tonsillitis. ClinTher 1991; 13: 579–88PubMedGoogle Scholar
  10. 10.
    Portier H, Waldner-Combernoux A, Clarysse L, et al. Cefpodoxime proxetil vs amoxicillin in the treatment of pharyngitisltonsillitis in adult out–patients [poster no. 33]. Intemational Congressfor Infectious Diseases: 1990 July 15-19; Montreal: 110–2Google Scholar
  11. 11.
    Portier H, Chavanet P, Waldner-Combernoux A, et al. Five versus ten days’ treatment of streptococcal pharyngotonsillitis: a randomizedcontrolled trial comparing cefpodoxime proxetil andphenoxymethyI penicillin. Scand J Infect Dis 1994; 26: 59–66PubMedCrossRefGoogle Scholar
  12. 12.
    Portier H, Chavanet P, Waldner-Cohen R, et al. Five days’ cefpodoxime proxetil (RU 51807) vs ten days’ penicillin Vfor streptococcal pharyngitis/tonsillitis in chiIdren [abstractno. 1674]. Interscience Conference on Antimicrobial Agentsand Chemotherapy; 1994 Oct 11-14; Anaheim (CA): 390Google Scholar
  13. 13.
    Portier H, Weber P, Gehanno H, et al. Recurrent tonsillitis in adult patients: a comparative clinical evaluation of cefpodoximeproxetil 5 days versus two other betalactam therapieslO days [abstract no. 1230]. International Congress for Infectious Diseases; 1994 Apr 26–30; PragueGoogle Scholar
  14. 14.
    Data on file, Roussel Vclaf, 1993Google Scholar
  15. 15.
    VIDAL 1993. Paris: Edition du Vidal, 1993Google Scholar
  16. 16.
    Journal officiel de la République Franςaise 1992; 153: 8854Google Scholar
  17. 17.
    VCANSS. Nomenclature Générale des Actes Professionnels et des Actes de Biologie Médicale. Vnion des Caisses Nationalesde Sécurité Sociale, 1990: 1–105Google Scholar
  18. 18.
    CNAMTS. Statistiques Mensuelles; résultats à fin Novembre 1992. Caisse Nationale d’Assurance Maladie des TravailleursSalariés, 1990: 25Google Scholar
  19. 19.
    Koopmanschap MA, Rutten FFH, van Ineveld BM, et al. The friction cost method for measuring indirect costs of disease. J Health Econ 1995; 14: 171–89PubMedCrossRefGoogle Scholar
  20. 20.
    Pelc A, Montron A, Ichou F, et al. Cefpodoxime proxetil5 days versus penicillin V lO days in adult patients with GABS pharyngitis:a cost–effectiveness analysis [poster]. The 18th International Congress of Chemotherapy; 1993 Jun 27–Jul 2; Stockholm: 387Google Scholar

Copyright information

© Adis International Limited 1996

Authors and Affiliations

  • Alain Pelc
    • 1
  • Henri Portier
    • 2
  • Pierre Gehanno
    • 3
  • Sylvie Fiessinger
    • 4
  • Françoise Ichou
    • 5
  1. 1.Health Economics DepartmentIMS International92882 Nanterre CTC Cedex 9France
  2. 2.Service des Maladies InfectieusesHopital du BocageFrance
  3. 3.Service d’ ORLHopital Bichat Claude BernardFrance
  4. 4.Roussel UCLAFFrance
  5. 5.Laboratoires DiamantFrance

Personalised recommendations