Pharmacoeconomic evaluation of cefuroxime sodium acquired through centralized bulk purchasing versus importation for perioperative prophylaxis in obstetrics and gynecology

To evaluate the pharmacoeconomics of centralized bulk purchasing (clustered purchasing) and imported cefuroxime sodium for injection in the perioperative preventive medication of obstetrics and gynecology department. A retrospective cohort study was conducted, and 408 obstetric and gynecological patients admitted to Jiaxing Maternal and Child Health Hospital from January to December 2021 were included in the study. According to the perioperative antibiotics, they were divided into an imported group and a centralized procurement group. The propensity score matching method (PSM) was used to balance the confounding factors, and the postoperative clinical infection indicators, maximum body temperature, hospital stay, postoperative infection, and cost-effectiveness analysis (CEA) were compared. A total of 132 groups of patients were successfully matched after PSM. There were no significant differences in hospital stay [(6.12±0.28) d], first postoperative white blood cell count [(8.40±0.56)×10 9 /L], highest postoperative temperature [(37.16±0.04)℃], and total preventive efficacy [93.9% (124/132)] in the centralized procurement group compared with (6.21±0.16) d, (7.83±0.44)×10 9 /L, (37.16±0.03)℃, and 95.5% (126/132) in the imported group ( t = -0.28, 0.80, 0.02, χ 2 = 0.30, all P > 0.05). The antimicrobial drug cost of the centralized procurement group was [50.70 (33.80, 67.60)] yuan and the total cost of western medicine [(831.41±39.13) yuan] was lower than that of the imported group [70.48 (35.24, 105.72)] yuan and (975.98±46.35) yuan, respectively (Z = -7.70, t = -2.38, both P < 0.05). Comparing the cost/effectiveness ratio of the two costs, the centralized procurement group (0.54, 8.85) was lower than the imported group (0.74, 10.22), respectively. Taking the centralized procurement group as the benchmark, for every 1% increase in the preventive efficacy, the incremental antimicrobial drug cost and incremental total cost of western medicine required by the imported group were 12.36 yuan and 90.36 yuan, respectively. The centralized procurement and imported cefuroxime for injection are effective in preventing postoperative infection in obstetrics and gynecology. The cost-effectiveness ratio of centralized procurement cefuroxime is better than that of imported products, and it has more economic advantages.