Cost savings associated with timely treatment of botulism with botulism antitoxin heptavalent product

English version

Autoři: Deborah M. Anderson ^aff001; Veena R. Kumar ^aff002; Diana L. Arper ^aff003; Eliza Kruger ^aff003; S. Pinar Bilir ^aff003; Jason S. Richardson ^aff001
Působiště autorů: Emergent BioSolutions Canada Incorporated, Winnipeg, Manitoba, Canada ^aff001; Emergent BioSolutions Incorporated, Gaithersburg, Maryland, United States of America ^aff002; IQVIA, San Francisco, California, United States of America ^aff003
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0224700

Souhrn

Background

Botulism is a rare, serious, and sometimes fatal paralytic illness caused by exposure to neurotoxins produced by Clostridium botulinum bacteria. Patients with documented or suspected exposure to botulinum toxin serotypes A-G can be treated with BAT^® [Botulism Antitoxin Heptavalent (A, B, C, D, E, F, G)–(Equine)] product, which was approved in 2013 in the United States (US). Patients with botulism have demonstrated greater clinical benefit with early BAT product treatment (≤2 days from symptom onset) versus late treatment (>2 days).

Objective

Economic outcomes associated with improved clinical outcome benefits of BAT product treatment have not yet been reported. This ad hoc analysis aimed to estimate and compare costs associated with hospitalization, intensive care unit stay, and mechanical ventilation for patients with botulism administered BAT product treatment early or late.

Methods

Clinical outcomes data for early and late BAT product treatment were obtained from a patient registry conducted between October 2014 and July 2017. Total per patient mean daily costs were estimated based on information from published literature. Total population costs per group were calculated by multiplying estimated mean cost per patient by the average annual number of non-infant botulism cases in the US.

Results

Mean per patient costs were 2.5 times lower for patients treated with BAT product early versus late. On average in the US, early BAT product treatment could save greater than $3.9 million per year versus late treatment.

Conclusion

Substantial economic savings can be achieved with early BAT product treatment. The findings support the recommendation for public health authorities to ensure antitoxin treatment is readily available in sufficient quantities to manage botulism cases, including sporadic outbreaks and potential mass exposure biological attacks.

Klíčová slova:

Hospitals – Public and occupational health – Toxins – Intensive care units – Botulinum toxin – Neurotoxins – Antitoxins – Botulism

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