The Cost-Effectiveness of Beta-Lactam Desensitization in the Management of Penicillin-Allergic Patients
Rodríguez-Alarcón, Alicia (Universitat Autònoma de Barcelona)
Grau, Santiago (Hospital del Mar (Barcelona, Catalunya))
Gómez-Zorrilla, Silvia (Hospital del Mar (Barcelona, Catalunya))
Rubio-Terrés, Carlos (Health Value)

Date:	2025
Abstract:	Background/Objectives: Antibiotic management of hospitalized penicillin-allergic patients (PAPs) is associated with prolonged hospital stays, adverse reactions and treatment failure, resulting in increased healthcare costs. This study aimed to estimate the cost-effectiveness of beta-lactam desensitization (DES) in the management of PAPs. Methods: A cost-effectiveness analysis was performed using a probabilistic model with 1000 s-order Monte Carlo simulations. Hospital costs (in 2025 Euros) and effectiveness outcomes (cure and survival rates) were derived from a Spanish retrospective case-control study conducted between 2015 and 2022, which included 56 PAPs (14 in the desensitization group [DES] and 42 in the control group without DES [NDES]; ratio 1:3), and collected healthcare costs per patient. Results: The incremental cost of the DES group was EUR 37,805 (95% CI: EUR 2023-EUR 126,785), with a 100% probability of incurring additional costs compared to the NDES group. The cure rate was 16. 5% higher in the DES group (95% CI: 13. 3-20. 0%), and the estimated gain in life-years per patient (LYG) was 1. 42 (95% CI: 1. 15-1. 73) versus NDES. The cost per life-year gained (LYG) with DES versus NDES was EUR 24,618 ± EUR 19,535 (95% CI: EUR 1755-EUR 73,488). The probability that DES would be cost-effective (cost per LYG < EUR 25,000 and <EUR 30,000) was 61. 1% and 100%, respectively. Conclusions: According to this analysis, DES appears to be a cost-effective option for managing PAPs. These findings should be confirmed in clinical studies with larger sample sizes.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Desensitization ; Cost-effectiveness ; Penicillin allergy ; Antimicrobial stewardship programs
Published in:	Antibiotics, Vol. 14 Núm. 7 (June 2025) , ISSN 2079-6382

DOI: 10.3390/antibiotics14070646
PMID: 40723949

8 p, 190.2 KB

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