Economic Evaluation of Landiolol vs Standard of Care for the Treatment of Patients with Sepsis-Related Tachyarrhythmia in Italy
DOI:
https://doi.org/10.7175/fe.v27i1.1607Keywords:
Landiolol, Sepsis-related tachyarrhythmia, Cost-effectiveness analysis, Budget impact analysis, Italian healthcare settingAbstract
INTRODUCTION: Septic shock is frequently complicated by tachyarrhythmias, which are associated with a poorer prognosis and increased intensive care unit stays. Landiolol, an ultra-short acting β-blocker, is effective in controlling heart rate (HR) and controlling cardiac arrhythmias in patients with sepsis. However, economic evaluations of its use remain limited. This study explores the potential economic benefits of landiolol compared to standard of care (SoC) in the Italian acute/emergency care setting.
METHODS: A decision model was developed to evaluate the cost-effectiveness and budget impact of landiolol versus SoC to manage sepsis-related tachyarrhythmia. The clinical benefit was expressed in terms of percentage change in patients reaching HR target. The economic model of landiolol was designed based on Landi-SEP trial. Costs were calculated from the hospital perspective and were derived from literature and national tariffs. A deterministic one-way sensitivity analysis was performed to assess the robustness of the cost-effectiveness analysis, and three alternative scenario analyses were performed on the budget impact analysis.
RESULTS: In the cost-effectiveness analysis, the mean total cost per patient was estimated to be €27,632 for those treated with landiolol vs €30,992 with SoC, corresponding to a difference of −€3,360 per patient. Despite pharmacological costs being higher in the landiolol group, patients treated with landiolol had a reduction of costs associated with hospital stay (−€4,251 per patient) compared with SoC. In the budget impact base case analysis, the gradual use of landiolol was associated with a decrease in the overall healthcare expenditure, with cumulative savings of approximately €22.5 million over three years. The projected expenditure for landiolol is offset by the reduction in expenditure on the other healthcare resources included in the analysis, primarily hospital stay.
CONCLUSION: The use of landiolol may reduce hospital costs in the Italian setting. Additional studies are needed to confirm these results in a larger population.
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Copyright (c) 2026 Filippo D'Amico, Matteo Marzaroli, Luana Bortone, Sonia Tomasso, Ilaria Bozzari, Laura Vincenzi, Alisa M. Higgins, Giacomo Monti
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