Method: Given MRSA NP is acquired during hospital stay, a hospital population budget impact model was constructed using local epidemiological data (Liu, Y: 2012). Drug acquisition and direct medical costs in 16 Tier-3A hospitals across 4 geographically representative Chinese cities were averaged to provide estimates for an overall national budget impact of a total of 773 Tier-3A hospitals in China with each being assumed to receive annual average of 20,000 in-patients. The data reported in the recent head-to-head study (Wunderink, CID: 2012) were referenced to provide model inputs on efficacy and resource use. Survey with local clinicians suggested equal adoption rates between linezolid and branded vancomycin were common in current clinical practice. The budgetary impact of having more patients treated with linezolid was explored at both national and city levels. Scenario analyses such as removal of hospital margin of 13% on drug costs as part of the national healthcare reform were conducted. All costs were reported in 2013 Chinese RMB.
Result: At the national level, an increase of total budget of ¥972,156 was estimated when the proportion of patients treated with linezolid increased from 50% to 70%, equivalent to additional ¥38.0 per treated patient. Similarly, an incremental budget of ¥11,603, ¥349 and ¥47,052 was estimated for Beijing, Nanjing and Xi’an, respectively. In Guangzhou, a total cost saving of ¥20,210 was predicted. In the scenario of removing margin on drug costs, the increase at the national level reduced to ¥218,271, equivalent to additional ¥8.5 per treated patient. Total budget savings were estimated in the same scenario for Beijing, Guangzhou and Nanjing while a smaller increase was estimated in Xi’an.
Conclusion: With its better treatment outcomes reported in the head-to-head study, an increased adoption of linezolid in treating MRSA NP is likely to cause relatively small incremental budget with potential of cost savings to payers in China attributed to partial total cost offset by better efficacy and hence shorter hospital stay for patients treated with linezolid.