Cost-effectiveness analysis of two inhaled antibiotics for stable Bronchiectasis with Pseudomonas aeruginosa infections in China

PMCID: PMC12176172

PMID: 40531911

DOI: 10.1371/journal.pone.0324254

Journal: PloS one

Publication Date: 2025-6-18

Authors: Chen W, Chen X, Lai L, Hong B, Zhi C, et al.

Key Points

• TIS provides a cost-effective alternative to CMS for Bronchiectasis patients with Pseudomonas aeruginosa infections
• Cost savings of CNY 41,109.53 per patient with a minimal QALY increment of 0.0048
• Robust analysis supports TIS as a preferred treatment strategy from both clinical and economic perspectives

Summary

This cost-effectiveness analysis evaluated two inhaled antibiotic strategies for managing Bronchiectasis (BE) with Pseudomonas aeruginosa (PA) infections in China's healthcare system. Using a sophisticated four-state Markov model over a one-year horizon, researchers compared Tobramycin Inhalation Solution (TIS) against nebulized Colistimethate Sodium (CMS), examining both clinical outcomes and economic implications.

The study revealed that TIS not only demonstrated superior clinical performance but also generated substantial economic advantages. Over the one-year simulation, TIS dominated CMS by saving CNY 41,109.53 (USD 5,689.27) per patient while marginally improving quality-adjusted life years (QALYs). Probabilistic sensitivity analyses consistently confirmed TIS's economic superiority, with a 100% probability of cost-effectiveness at the willingness-to-pay threshold, making a compelling case for its preferential use in managing BE with PA infections.