Clostridium difficile is the most serious cause of antibiotic-associated diarrhoea, which, in turn, is the most common type of infection experienced by people who are hospitalised. Faecal microbiota transplantation (FMT) has been recently shown in a randomised controlled trial to be effective for the treatment of recurrent Clostridium difficile infection (CDI). The aim of this thesis is to evaluate the cost-effectiveness of FMT compared with vancomycin for the treatment of CDI in Australia.
A Markov model was developed to compare the cost-effectiveness of FMT compared with standard antibiotic therapy, using a societal perspective. A literature review of clinical evidence informed the structure of the model and the parameters used in the model. Clinical effectiveness was measured in terms of quality adjusted life years (QALYs). Univariate, multivariate, and probabilistic sensitivity analysis was used to explore uncertainty in the model.
Compared with vancomycin, the use of FMT results in an expected cost savings of $5,914 per CDI patient and a gain of 0.86 QALYs per patient. If FMT replaced vancomycin therapy for the treatment of recurrent CDI in Australia then the expected cost savings would be $1,283,000 to $3,566,000 per year with a yearly gain of 187 to 519 QALYs.
FMT is cost saving compared with standard antibiotic therapy for the treatment of recurrent CDI.