Health economic evaluation: Prophylactic use of Enterol for prevention of antibiotics-associated diarrhea in hospitalized patients

06 juni 2019

In Europe, about one third of patients receives antibiotic (AB) therapy during hospitalization. A common adverse effect of AB treatment is the development of antibiotic-associated diarrhea (AAD) with symptoms ranging from mild to severe attacks. AAD, and particularly the more severe forms of Clostridium difficile infection, may result in increased diagnostic procedures, extended hospital stay and increased medical care costs. Enterol (S. Boulardii CNCM-i775) is a pharmaceutical probiotic with proven efficacy in reducing the risk for development of AAD. This study translates these clinical findings to meaningful economic outcomes relevant for hospitals and payers alike.

Expertise: Health Economics, Stakeholder Messaging

Project Highlights

  • Customer: Biocodex
  • Main Goal: Demonstrate and communicate the cost-saving nature of generalized prophylactic use of Enterol for prevention of AAD in hospitalized patients
  • Main Result: (i) Analysis of the perception and clinical practice of AAD; (ii) Belgian prevalence study; (iii) Belgian hospital healthcare resource use study and (iv) health economic model. Results were published in a series of peer-reviewed publications and scientific posters

This project is a prime example of a start-to finish strategic partnership in which Hict was involved from the get-go providing assistance in shaping the strategic priorities up to providing the building blocks for further messaging in the form of a series of publications and scientific presentations supporting Enterol’s economic value message.


The first phase of the project comprised primary and secondary market research to finetune the strategic priorities of the follow-up research.

Next, a roadmap was drafted towards development of targeted stakeholder messaging focused on the health-economic profile of enterol prophylaxis for AAD in hospitalized patients. Given the lack of suitable Belgian data, this roadmap included setting up & running a prevalence study in collaboration with the Centre for Research and Innovation in Care of the University of Antwerp coupled to a resource use survey across different wards in 2 different hospital groups in Belgium.

The results of these studies were tied together with the outcomes of a structured literature search to fuel development of a health economic (cost minimization) model taking into account the different stakeholder perspectives of interest for follow-up communication.

The outcomes of the health economic analysis and its building blocks were the subject of 2 peer reviewed papers and a number of posters and presentations at international scientific conferences


Data collection for prevalence (absolute risk of) of antibiotic associated diarrhea (AAD) for hospitalized patients in Belgium

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Screenshot www ageb be 2021 01 26 10 14 05

Economic evaluation of S. boulardii CNCM I-745 for prevention of antibioticassociated diarrhea in hospitalized patients.

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Aad cost hospitalised patients

The cost of Antibiotic-Associated Diarrhea (AAD) in hospitalised patients

AAD indence risk treatment

Antibiotic associated diarrhea: incidence, risk factors and treatment

See poster