Pharmacoeconomic evaluation of cefuroxime sodium acquired through centralized bulk purchasing versus importation for perioperative prophylaxis in obstetrics and gynecology
Objective To assess the pharmacoeconomic implications of injectable cefuroxime sodium acquired through centralized bulk purchasing versus importation for perioperative prophylaxis in obstetrics and gynecology.Methods A retrospective cohort study was conducted involving 408 patients treated at the Department of Obstetrics and Gynecology at Jiaxing Maternity and Child Health Care Hospital from January to December 2021.The patients were divided into two groups based on the type of perioperative antimicrobial agents used:the importation group and the centralized bulk purchasing group.Propensity score matching was used to balance confounding factors.Postoperative clinical infection indicators,maximum body temperature,length of hospital stay,and incidence of postoperative infections were compared between the two groups.Additionally,a cost-effectiveness analysis was performed.Results After propensity score matching,a total of 132 patients were successfully matched.In the centralized bulk purchasing group,the length of hospital stay,first postoperative white blood cell count,maximum body temperature,and overall prophylactic effectiveness rate were(6.12±0.28)days,(8.40±0.56)× 109/L,(37.16±0.04)° C,and 93.9％(124/132),respectively.In comparison,the corresponding values in the importation group were(6.21±0.16)days,(7.83±0.44)× 109/L,(37.16±0.03)℃,and 95.5％(126/132).The differences in these measurements between the two groups were not statistically significant(t=-0.28,0.80,0.02,x2=0.30,all P＞0.05).In the centralized bulk purchasing group,the antimicrobial drug cost was 50.70(33.80,67.60)yuan,and the total cost of Western medicine was(831.41±39.13)yuan.Both of these costs were significantly lower than those in the importation group[70.48(35.24,105.72)yuan,(975.98±46.35)yuan,Z=-7.70,t=-2.38,both P＜0.05].The cost-effectiveness ratio of the centralized bulk purchasing group and the importation group was 0.54 and 8.85,respectively,which were lower than those in the importation group(0.74,10.22).Using the prevention effectiveness of the centralized bulk purchasing group as a baseline,every 1％increase in prevention effectiveness in the importation group resulted in additional costs of 12.36 yuan for antimicrobial drugs and 90.36 yuan for total Western medicine.Conclusion Injectable cefuroxime sodium acquired through both centralized bulk purchasing and importation is highly effective in preventing postoperative infections in obstetrics and gynecology.A cost-effectiveness analysis shows that the injectable cefuroxime sodium obtained through centralized bulk purchasing is more cost-effective than the imported approach,resulting in greater economic benefits.
CefuroximeGroup purchasingCosts and cost analysisGynecologic surgical proceduresPerioperative periodAnti-bacterial agentsEconomics,pharmaceutical
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