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Kelompok 10
Lucya Andreany (1400023178)

Arinda Rani Astuti (1400023184)

Deki Nusfirianda (1400023185)

Rizki Aulia Nurfajriati (1400023186)

Deviani Risqi Ifani Sari (1400023187)

Kurnia Ambarwati (1400023188)


Complete title
The title did identify the two
therapeutic options that were being
compared between imipenem/cilastatin
(IC) and meropenem (MEM). The title
did indicate that the type of study was
a CMA.
Clear objective
The objective was to compare the
costs of management of moderate to
severe infections in patients treated
with imipenem/cilastatin (IC) and
meropenem (MEM). This was clear.
Approriate alternatives
The authors explained why the
alternatives were important and
references clinical literature to back up
the similarity of outcomes and activity
with acquisition costs.
Alternatives described
The dosing and days of dosing
were listed.
Perspective stated
The perspective of the economic
evaluation was that of the provider
or payer, in this case the Ministry of
National Guard in Saudi Arabia that
provides health-care to eligible
Type of study
This study was a retrospective,
single-centre cohort employing CMA
principles. The CMA assumes that
consequences are equivalent while
seeking the least expensive alternative.
Relevant costs
Based on the payer perpective, only
direct medical costs related to the
management of the infections were
included. Direct medical costs included
the costs of medications, laboratory
tests, health care provider costs,
hospitalization costs, consumables and
administration costs.
Relevant outcomes
Overall there was no difference in the
mean total daily costs between IC and
MEM. A significantly lower medicine
acquisition cost per vial of IC was
observed when compared to MEM,
there was a significantly higher cost
attached to administration sets used in
the IC group than the MEM group.
Adjusment or discounting
Discounting was not considered as the
study period was for a single year.
Pricing was in Saudi riyals (SARs). One
SAR has been fixed at approximately
0.27 United States dollars (USD) for
the last 10 years.
Reasonable assumptions
In order to justify the CMA approach
used in this study, a literature review
was first conducted to justify the a
priori assumption of clinical
equivalence of IC and MEM in the
types of infections treated and the
doses recommended in the KAH
Sensitivity analysis
One-way sensitivity analysis showed
that the parameters which exerted the
greatest change in the mean total cost
Were the number of CCU days,
laboratory tests and consultation
Limititations addressed
This study was not without limitations.
It was a retrospective single-cohort
study that reflected the practices of a
single institution. Although a census
approach over a calendar year was
used, the sample size was small.
Generalizations appropriate
This study has shown that mean total
costs per day were not significantly
different between IC and MEM,
indicating that medicine costs are only
a small element of the overall costs
ofmanaging moderate to severe
Unbiased conclusions
This retrospective review found that although
acquisition costs for IC are significantly less than
those for MEM, the mean total costs per day
associated with these competing carbapenems were
significantly different.

The results underlined the fact that medicine

acquisition costs are only a small component of the
overall costs of managing moderate to severe