6 ________ .I.n.t.e.r.n.a __ t.iD __ n.a.l __ R.e.s.e.a_.r.c.h __ a.n.d_.O __ p.i.n.i.D.n ________ _ Lower delivery costs reduce overall costs for meropenem

Meropenem has substantial delivery time and cost advantages over imipenem/cilastatin, especially when administered by rapid injection, reports Mr Richard Plumridge of Fremantle Hospital and Health Service, Australia.

As the important differential cost factors for meropenem and imipenem/cilastatin are acquisition and delivery costs, Mr Plumridge determined the differences in the total delivery costs for these 2 carbapenems. * Labour costs were calculated using the average weighted nurse salary, together with the time required by registered nurses to prepare and administer: rapid injections and infusions of meropenem 500mg and Ig ['Merrem' vials]; and IV infusions ofimipenem/ cilastatin 500mg/500mg and Ig/lg ['Primaxin' vials]. Labour costs and consumable costs were added to determine the total delivery cost for the 2 drugs.

Comparison with imipenem/cilastatin The total delivery cost per dose of meropenem by

rapid injection was 54 and 79% (500mg dose) and 88 and 112% (lg dose) less expensive than imipenem/ cilastatin infusion via an existing or a new IV line, respectively. The total delivery cost per dose of meropenem infusion was 26 and 21 % ( 500mg dose) and 54 and 45% (lg dose) less expensive than imipenem/ cilastatin infusion via an existing or a new IV line, respectively.

The substantially lower delivery cost of meropenem by injection, compared with either meropenem infusion or imipenem/cilastatin infusion, occurred because of lower labour costs due to shorter delivery times, as well as substantially lower consumable costs.

Total daily costs (acquisition and delivery costs) of meropenem were less than those of imipenem/cilastatin, depending on the administration method and dosage frequency used [see table].

Total daily cost of meropenem and imipenem/cilastatin ($A)*

Drug .rid .-.glmen Acqulaitlon DelIvwy coM TlMldtII/y coet per doee perdoee coet"

Menlpetlem

500mg 3 times dally 26.67 6.26 98.79

19 3 times daily 53.34 6.86 180.80

Jmlpenemlcllamlln

5OOmgI5OOmg 24.81 9.64 103.35 3 times dally

1 If! 9 3 times dally 49.62 12.93 187.65

5OOmgI5OOmg 24.81 9.64 137.80 4 Umesdally

1 gil g 4 times dally 49.62 12.93 250.20

• 1997 Australian dollars ($A 1 = SUSO.76)

.. Cost per dose muttiplled by the number of do6es administered dally.

* The study was undertaken as part of a phase III trial conducted by leI Pharmaceuticals in Melbourne, Australia.

Plumridge Rl. Cost analysis of infusion versus injection delivery of imipenem/cilastatin and meropenem. Clinical Drug Investigation 14: 132·136, Aug 1997 800531088

PharmacoEconomics & Outcomes News 16 Aug 1997 No. 125 1173.5503197/0125.00061$01.00° Adi. International Limited 1997. All ri9ht. reserved