Distributional Cost-Effectiveness Analysis of Penicillin Allergy De-labelling in the European Union

This repository contains the R script and supporting materials for a distributional cost-effectiveness analysis (DCEA) of penicillin allergy de-labelling across the 27 EU member states. The model compares uniform versus targeted rollout strategies, quantifying both efficiency (QALYs, cost savings) and equity (equally distributed equivalent QALYs, equity-weighted net health benefit) outcomes. Inputs include demographic data from Eurostat Demographics 2025 and antimicrobial resistance indices from the ECDC EARS-Net Annual Epidemiological Report 2023. Conservative effectiveness and cost parameters were derived from peer-reviewed literature. The outputs include incremental QALYs, cost savings, net health benefits, equity-weighted outcomes, probabilistic sensitivity analyses, and an equity–efficiency visualization.<br>