Societal willingness to pay to avoid mortality and morbidity from Clostridioides difficile and carbapenem-resistant Enterobacteriaceae infections in the United States.
BACKGROUND
Clostridioides difficile infection (CDI) is among the most common health care-associated infections in the United States and is increasingly affecting the elderly. Although carbapenem-resistant Enterobacteriaceae (CRE) infections are still relatively uncommon, there are reported increases in the rate of infection for certain strains, such as Klebsiella pneumoniae. This study examines the burden of mortality and morbidity for CDI and CRE infections in the United States and estimates the societal willingness to pay to avoid them.


METHODS
We use an analytic model to estimate the number of incident cases and associated health outcomes for CDI and CRE infections.


RESULTS
The number of CDI and CRE infection incident cases in the United States in 2016, is estimated at 468,567 and 9,620, respectively. These infections result in a total of 17,630 estimated deaths and 8,624 lost quality-adjusted life years among patients who survive per year.


CONCLUSIONS
Given the significant mortality and morbidity from these infections, the estimated societal willingness to pay to avoid them is high at $176.7 billion per year, of which 93.9% ($166.0 billion) is for CDI. Our estimates far exceed the medical care costs for CDIs and CRE infections reported in the literature despite not capturing the additional costs borne by third-party payers. As incident cases increase or resistant strains develop, the societal willingness to pay is also expected to increase.
['Sertkaya|Aylin|A|', 'Wong|Hui-Hsing|HH|', 'Ertis|Daniel H|DH|', 'Jessup|Amber|A|']
D000900:Anti-Bacterial Agents D000073182:Carbapenem-Resistant Enterobacteriaceae D015780:Carbapenems D003013:Clostridium D003015:Clostridium Infections D003428:Cross Infection D004756:Enterobacteriaceae Infections D006801:Humans D007711:Klebsiella pneumoniae D009017:Morbidity D014481:United States
Quality-adjusted life years Avoided morbidity value Avoided mortality value Value of a statistical life Value of a statistical life year