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Carol J. Fairchild, Trent McLaughlin, Ken O'Day; Cost-effectiveness Of Moxeza. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5547.
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To assess the cost effectiveness of moxafloxacin AF (Moxeza) for the management of bacterial conjunctivitis from the payer’s perspective. This study sought to examine the cost-effectiveness of Moxeza as compared to moxafloxacin (Vigamox®), gatifloxacin (Zymar®), and besifloxacin (Besivance®) based on achievement of therapeutically efficacious concentrations in the conjunctiva for the treatment of bacterial conjunctivitis.
The cost-effectiveness approach used in this study integrated potency data, pharmacokinetic information, pharmacodynamics, and drug acquisition costs. The antibiotic therapeutic index (TI) combines in vitro MIC data with in vivo penetration data to compare the clinical efficacy of antibiotics. TI, the ratio of Cmax:MIC , weighted by the prevalence of each pathogen, served as the effectiveness parameter. Drug costs were based on wholesale acquisition costs (WAC), estimated using national average wholesale prices published in the Drug Topics Red Book 2010. The robustness of the model was tested with regard to changes in the values of key parameters. One-way sensitivity analyses were conducted by varying each parameter one at a time across a plausible range of values, while holding all others constant, and calculating the effect on the budgetary impact estimate for each change.
The TI values are Moxeza: 642.00; Vigamox: 356.67; Zymar: 202.90; and Besivance: 91.04. The average cost per TI was Moxeza: $0.11; Vigamox: $0.20; Zymar: $0.34; and Besivance: $0.79. Sensitivity analyses varying the potency (MIC) values resulted in changes to the TI. Using MIC90 as opposed to MIC50 values resulted in a lower TI across all agents, however with Moxeza remaining a cost-effective antibiotic.
Overall, findings from this study indicate that Moxeza achieved therapeutic concentrations in the relevant ocular tissues and had higher therapeutic index values due to its better pharmacokinetic properties and greater in vitro potency compared to the other advanced fluoroquinolones. Moreover, the higher therapeutic index of Moxeza was provided at a comparable cost to other fluoroquinolones, thus increasing its value for treatment of bacterial conjunctivitis.
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