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Introduction <p>Clinical studies have shown that omadacycline is non-inferior to moxifloxacin, a widely used respiratory fluoroquinolone, in terms of efficacy. However, the higher acquisition cost of omadacycline raises questions regarding its economic value, particularly in resource-limited healthcare systems such as China.</p> Aim <p>This study evaluated the cost-effectiveness of omadacycline versus moxifloxacin as initial treatment for CABP in China.</p> Method <p>A decision-tree model was constructed using TreeAge Pro 2020 to assess sequential intravenous (IV)-to-oral omadacycline versus moxifloxacin in adult patients with non-severe CABP. Parameter values were obtained from published literature, public databases, and medical service pricing datas. Incremental cost-effectiveness ratios (ICERs) were calculated, and sensitivity analyses were performed to assess model robustness. A regimen was considered cost-effective if the ICER fell below the willingness-to-pay (WTP) threshold of $19,012 per quality-adjusted life year (QALY).</p> Results <p>In the base-case analysis, omadacycline provided an additional 0.004 QALY at an incremental cost of $597.8, resulting in an ICER of $148,700/QALY—substantially exceeding the $19,012 threshold. The cost of oral and IV omadacycline were the most influential parameters. Omadacycline was optimal in 7.6% of 10,000 Monte Carlo simulations at the $19,012/QALY threshold. Province-specific WTP thresholds showed cost-effectiveness probabilities ranging from 1.1% (Gansu) to 16.2% (Beijing).</p> Conclusion <p>Omadacycline is not cost-effective compared to moxifloxacin as the initial treatment for CABP in China, unless significant price reductions are achieved.</p>

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Cost-effectiveness of omadacycline versus moxifloxacin as the initial treatment for community-acquired bacterial pneumonia in China

  • 期刊论文

  • 发表日期：

    2025年11月12日

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  • Xiuling Wang,
  • Yao Fu,
  • Guijun Duan,
  • Wenqiang Kong

摘要

Introduction

Clinical studies have shown that omadacycline is non-inferior to moxifloxacin, a widely used respiratory fluoroquinolone, in terms of efficacy. However, the higher acquisition cost of omadacycline raises questions regarding its economic value, particularly in resource-limited healthcare systems such as China.

Aim

This study evaluated the cost-effectiveness of omadacycline versus moxifloxacin as initial treatment for CABP in China.

Method

A decision-tree model was constructed using TreeAge Pro 2020 to assess sequential intravenous (IV)-to-oral omadacycline versus moxifloxacin in adult patients with non-severe CABP. Parameter values were obtained from published literature, public databases, and medical service pricing datas. Incremental cost-effectiveness ratios (ICERs) were calculated, and sensitivity analyses were performed to assess model robustness. A regimen was considered cost-effective if the ICER fell below the willingness-to-pay (WTP) threshold of $19,012 per quality-adjusted life year (QALY).

Results

In the base-case analysis, omadacycline provided an additional 0.004 QALY at an incremental cost of $597.8, resulting in an ICER of $148,700/QALY—substantially exceeding the $19,012 threshold. The cost of oral and IV omadacycline were the most influential parameters. Omadacycline was optimal in 7.6% of 10,000 Monte Carlo simulations at the $19,012/QALY threshold. Province-specific WTP thresholds showed cost-effectiveness probabilities ranging from 1.1% (Gansu) to 16.2% (Beijing).

Conclusion

Omadacycline is not cost-effective compared to moxifloxacin as the initial treatment for CABP in China, unless significant price reductions are achieved.