An economic evaluation of Levofloxacin versus Cefuroxime Axetil in the outpatient treatment of adults with community-acquired pneumonia

Objective: To examine treatment costs of community-acquired
pneumonia (CAP) in adult outpatients
given oral (po) levofloxacin or cefuroxime axetil as
initial therapy.

Study Design: Patients with a primary diagnosis of
CAP were enrolled in a multicenter, prospective,
randomized, open-label, active-controlled Phase III
clinical trial. Both inpatients and outpatients were
assigned to 1 of 2 treatment groups: (1) intravenous
(IV) or po levofloxacin; or (2) IV ceftriaxone and/or
po cefuroxime axetil.

Methods: To make legitimate and meaningful cost
comparisons between similar types of patients
receiving drugs via the same route of administration
(ie, orally), this outpatient economic study examined
the resource utilization of the 211 patients enrolled
as outpatients who received oral formulations as initial
treatment (levofloxacin, 103 patients; cefuroxime
axetil, 108 patients). Resource utilization data
and clinical trial data were collected concurrently.
To generate cost estimates, Medicare cost estimates
for resources were multiplied by the resource units
used by patients in each treatment arm.

Results: Cost estimates indicated a total cost difference
that favored the levofloxacin group (base
case: $169; sensitivity analysis: $223 [P = .008]).
The results for the base case were not significant
(P = .094). In addition, within the cost categories,
there was a statistically significant study drug cost
differential favoring levofloxacin ($86; P = .0001 for
both the base case and sensitivity analysis).

Conclusion: Oral levofloxacin is less costly than
oral cefuroxime axetil in the outpatient treatment of
adults with CAP.
(Am J Manag Care 2000;6:381-389)