Comparisons of 30-Day Admission and 30-Day Total Healthcare Costs Between Patients Who Were Treated With Oritavancin or Vancomycin for a Skin Infection in the Outpatient Setting

Abstract

Objective Hospital admission is a key cost driver among patients with skin and soft tissue infections (SSTI). Data suggest that many SSTI patients are hospitalized unnecessarily and can be managed effectively and safely in an outpatient setting at a substantially lower cost. Oritavancin (ORI) is a single-dose treatment that has the potential to shift care from the inpatient to the outpatient setting. This study sought to compare the 30-day hospital admission rates and mean healthcare costs among SSTI patients who received outpatient ORI or vancomycin (VAN). Method Over a 1-year period, outpatient prescription claims for VAN and ORI among patients with SSTIs and no hospitalization in past 3 days were for VAN and ORI were analyzed using a retrospective cohort analysis of the Truven Health MarketScan Databases. Results During the study period, 120 and 6695 patients who received ORI and VAN, respectively, met inclusion criteria. Groups were well matched at baseline. After covariate adjustment, patients who received ORI had a significantly lower 30- day admission rate versus patients who received VAN (6.1% vs 16.2%, respectively; P = .003). Mean healthcare costs 30-day post index were comparable between ORI and VAN patients ($12 695 vs $12 717, respectively; P = 1.0). Conclusions Results suggest that ORI provides a single-dose alternative to multidose VAN for treatment of SSTI in the outpatient setting and may result in lower 30-day hospital admission rates.

Cost-minimisation analysis of oritavancin for the treatment of acute bacterial skin and skin structure infections from a United Kingdom perspective

“…Our analysis is consistent with previous economic studies from the US and other parts of Europe comparing treatment strategies and therapeutic options in ABSSSI care. A US retrospective, observational cohort analysis comparing 30-day hospital admission rates and mean healthcare costs among 6,815 patients with ABSSSI, who received outpatient oritavancin and vancomycin in patients using a health market scan database over a 1-year time period, showed significantly lower 30-day admission rate with oritavancin versus vancomycin (6.1% versus 16.2%) [43], consistent with the results of this oritavancin model. Results from this oritavancin study are also in line with a CMM comparing the costs of inpatient vancomycin versus outpatient oritavancin treatment of patients with ABSSSI from a premier research database in the US, where switching from inpatient vancomycin treatment to outpatient oritavancin treatment estimated to save $1752.46 to $6475.87 per patient [44].…”

Current and future options for treating complicated skin and soft tissue infections: focus on fluoroquinolones and long-acting lipoglycopeptide antibiotics

“…In the above-mentioned US retrospective chart review, oritavancin was associated with a lower 30 day subsequent hospital admission rate than vancomycin (6.1% versus 16.2%; P = 0.003). 126 This finding appears to be confirmed by the results of a descriptive retrospective cohort of adult inpatients with SSTIs who were discharged with single-dose oritavancin or oral step-down antibiotic therapy, revealing fewer 30 day SSTI-related readmissions in patients receiving oritavancin 7/99 (7.1%) compared with 18/100 (18.0%) with oral step-down therapy; 6 of the 7 readmissions in patients receiving oritavancin involved Gram-negative pathogens. 127 Meanwhile, a retrospective real world study comparing single-dose dalbavancin to standard of care in age- and BMI-matched adults with ABSSSI revealed more 30 day SSTI-related readmissions in patients treated with dalbavancin 55/209 (26.32%) compared with standard of care 31/209 (14.83%; P < 0.01).…”

“… 125 A retrospective chart review in US patients with SSTIs revealed that patients treated with oritavancin ( n = 120) had equivalent 30 day healthcare costs (12 695 versus 12 717 US$). 126 The largest 30 day cost component with oritavancin was associated with outpatient service visits (drug acquisition and administration costs), while costs with vancomycin were largely accounted for by inpatient admissions, emergency department visits, and outpatient services. 126 However, the study did not consider indirect costs incurred by patients receiving IV therapy and drug monitoring for 7–10 days, or benefits from reduced contact with the healthcare setting.…”

Oritavancin (KIMYRSA™) in acute bacterial skin and skin structure infections: a profile of its use in the USA

“…To improve patient clinical outcomes and resource utilization, several centres in the USA have implemented oritavancin as part of a multidisciplinary treatment program for ABSSSIs [12]. Indeed, real-world studies have suggested potential clinical and economic benefits associated with the single-dose IV oritavancin regimen in patients with ABSS-SIs where the treatment reduced disease progression rates [6], infection sequelae from ABSSSI treatment failures [35], 30-day hospital readmission rates [6,35,36] and/or length of hospital stays without affecting readmission rates [5,6]. Furthermore, pharmacoeconomic analyses (from the hospital perspective) of oritavancin versus vancomycin in patients with confirmed or suspected gram-positive ABSSSIs and risk of MRSA in the USA indicate that oritavancin is associated with substantial healthcare cost savings by lowering drug administration burden and reducing hospital admissions [37,38].…”