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Hospital visits and costs following outpatient treatment of CAP with levofloxacin or moxifloxacin.
Curr Med Res Opin. 2010 Feb; 26(2):355-63.CM

Abstract

BACKGROUND

Hospital admissions (inpatient and emergency room) are a major source of medical costs for community-acquired pneumonia (CAP) initially treated in the outpatient setting. Current CAP treatment guidelines do not differentiate between outpatient treatment with levofloxacin and moxifloxacin.

OBJECTIVE

Compare health care resource use and medical costs to payers for CAP outpatients initiating treatment with levofloxacin or moxifloxacin.

RESEARCH DESIGN AND METHODS

CAP episodes were identified in the PharMetrics database between 2Q04 and 2Q07 based on: pneumonia diagnosis, chest X-ray and treatment with levofloxacin or moxifloxacin. Subsequent 30-day risk of pneumonia-related hospital visits and 30-day health care costs to payers for levofloxacin vs. moxifloxacin treatment were estimated after adjusting for pre-treatment demographics, health care resource use and pneumonia-specific risk factors using propensity score and exact factor matching.

RESULTS

A total of 15,472 levofloxacin- and 6474 moxifloxacin-initiated CAP patients were identified. Among 6352 matched pairs, levofloxacin treatment was associated with a 35% reduction in the odds of pneumonia-related hospital visits (odds ratio = 0.65, P = 0.004), lower per-patient costs for pneumonia-related hospital visits (102 dollars vs. 210 dollars, P = 0.001), lower pneumonia-related total costs (medical services and prescription drugs, 363 dollars vs. 491 dollars, P < 0.001) and lower total costs (1308 dollars vs. 1446 dollars, P < 0.001) vs. moxifloxacin over the 30-day observation period.

LIMITATIONS

Although observational analyses of claims data provide large sample sizes and reflect routine care, they do have several inherent limitations. Since randomization of subjects is not possible, adequate statistical techniques must be used to ensure that patient characteristics are well-balanced between treatment groups. In addition, data may be missing or miscoded.

CONCLUSIONS

CAP outpatients initiated with levofloxacin generated substantially lower costs to payers compared to matched patients initiated with moxifloxacin. The cost savings for patients initiated with levofloxacin were largely attributable to reduced rates of pneumonia-related hospitalization or ER visits.

Authors+Show Affiliations

Analysis Group, Inc., Huntington Avenue, Tenth Floor, Boston, MA 02199, USA. jsignorovitch@analysisgroup.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19995325

Citation

Signorovitch, James E., et al. "Hospital Visits and Costs Following Outpatient Treatment of CAP With Levofloxacin or Moxifloxacin." Current Medical Research and Opinion, vol. 26, no. 2, 2010, pp. 355-63.
Signorovitch JE, Sheng Duh M, Sengupta A, et al. Hospital visits and costs following outpatient treatment of CAP with levofloxacin or moxifloxacin. Curr Med Res Opin. 2010;26(2):355-63.
Signorovitch, J. E., Sheng Duh, M., Sengupta, A., Gu, A., Grant, R., Raut, M., Mody, S. H., Schein, J., Fisher, A. C., & Ng, D. (2010). Hospital visits and costs following outpatient treatment of CAP with levofloxacin or moxifloxacin. Current Medical Research and Opinion, 26(2), 355-63. https://doi.org/10.1185/03007990903482418
Signorovitch JE, et al. Hospital Visits and Costs Following Outpatient Treatment of CAP With Levofloxacin or Moxifloxacin. Curr Med Res Opin. 2010;26(2):355-63. PubMed PMID: 19995325.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hospital visits and costs following outpatient treatment of CAP with levofloxacin or moxifloxacin. AU - Signorovitch,James E, AU - Sheng Duh,Mei, AU - Sengupta,Anirban, AU - Gu,Anna, AU - Grant,Richard, AU - Raut,Monika, AU - Mody,Samir H, AU - Schein,Jeff, AU - Fisher,Alan C, AU - Ng,Daniel, PY - 2009/12/10/entrez PY - 2009/12/10/pubmed PY - 2010/5/1/medline SP - 355 EP - 63 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 26 IS - 2 N2 - BACKGROUND: Hospital admissions (inpatient and emergency room) are a major source of medical costs for community-acquired pneumonia (CAP) initially treated in the outpatient setting. Current CAP treatment guidelines do not differentiate between outpatient treatment with levofloxacin and moxifloxacin. OBJECTIVE: Compare health care resource use and medical costs to payers for CAP outpatients initiating treatment with levofloxacin or moxifloxacin. RESEARCH DESIGN AND METHODS: CAP episodes were identified in the PharMetrics database between 2Q04 and 2Q07 based on: pneumonia diagnosis, chest X-ray and treatment with levofloxacin or moxifloxacin. Subsequent 30-day risk of pneumonia-related hospital visits and 30-day health care costs to payers for levofloxacin vs. moxifloxacin treatment were estimated after adjusting for pre-treatment demographics, health care resource use and pneumonia-specific risk factors using propensity score and exact factor matching. RESULTS: A total of 15,472 levofloxacin- and 6474 moxifloxacin-initiated CAP patients were identified. Among 6352 matched pairs, levofloxacin treatment was associated with a 35% reduction in the odds of pneumonia-related hospital visits (odds ratio = 0.65, P = 0.004), lower per-patient costs for pneumonia-related hospital visits (102 dollars vs. 210 dollars, P = 0.001), lower pneumonia-related total costs (medical services and prescription drugs, 363 dollars vs. 491 dollars, P < 0.001) and lower total costs (1308 dollars vs. 1446 dollars, P < 0.001) vs. moxifloxacin over the 30-day observation period. LIMITATIONS: Although observational analyses of claims data provide large sample sizes and reflect routine care, they do have several inherent limitations. Since randomization of subjects is not possible, adequate statistical techniques must be used to ensure that patient characteristics are well-balanced between treatment groups. In addition, data may be missing or miscoded. CONCLUSIONS: CAP outpatients initiated with levofloxacin generated substantially lower costs to payers compared to matched patients initiated with moxifloxacin. The cost savings for patients initiated with levofloxacin were largely attributable to reduced rates of pneumonia-related hospitalization or ER visits. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/19995325/Hospital_visits_and_costs_following_outpatient_treatment_of_CAP_with_levofloxacin_or_moxifloxacin_ L2 - https://www.tandfonline.com/doi/full/10.1185/03007990903482418 DB - PRIME DP - Unbound Medicine ER -