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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 2017 (2017), Article ID 6362804, 11 pages
Research Article

Cost-Effectiveness Analysis of Fosfomycin for Treatment of Uncomplicated Urinary Tract Infections in Ontario

1International Market Access Consulting, Montreal, QC, Canada
2University of Montréal, Faculty of Medicine, Montréal, QC, Canada
3Triton Pharma Inc., Concord, ON, Canada
4Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
5Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada

Correspondence should be addressed to Louise Perrault

Received 18 October 2016; Accepted 31 January 2017; Published 20 February 2017

Academic Editor: José A. Oteo

Copyright © 2017 Louise Perrault et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background and Objective. Bacterial resistance to antibiotics traditionally used to treat uncomplicated urinary tract infections (uUTIs) is rising in Canada. We compared the cost-per-patient in Ontario of including fosfomycin (an antibiotic with a low resistance profile) as an option for first-line empirical treatment of uUTIs with current cost of treatment with sulfonamides, fluoroquinolones, and nitrofurantoin. Methods. A decision-tree model was used to perform a cost-minimization analysis. All possible outcomes of a uUTI caused by bacterial species treated with either sulfonamides, fluoroquinolones, nitrofurantoin, or fosfomycin were included. Results. In the base case analysis, the cost-per-patient for treating uUTI with fosfomycin was $105.12. This is similar to the cost-per-patient for each of the other currently reimbursed antibiotics (e.g., $96.19 for sulfonamides, $98.85 for fluoroquinolones, and $99.09 for nitrofurantoins). The weighted average cost-per-patient for treating uUTI was not substantially elevated with the inclusion of fosfomycin in the treatment landscape ($98.41 versus $98.29 with and without fosfomycin, resp.). The sensitivity analyses revealed that most (88.34%) of the potential variation in cost was associated with the probability of progressing to pyelonephritis and hospitalization for pyelonephritis. Conclusion. Fosfomycin in addition to being a safe and effective agent to treat uUTI has a low resistance profile, offers a single-dose treatment administration, and is similar in cost to other reimbursed antibiotics.