Potential savings through single-dose intravenous Dalbavancin in long-term MRSA infection treatment – a health economic analysis using German DRG data

Wilke, Michael; Worf, Kerstin; Preisendörfer, Birgit; Heinlein, Wolfgang; Kast, Tilman; Bodmann, Klaus-Friedrich

doi:10.3205/id000043

Cited by 6 publications

(5 citation statements)

References 41 publications

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“…Additionally, it was estimated that the use of dalbavancin over standard therapy led to 1160 hospital days saved and an overall cost reduction of EUR 3064 per patient [10]. Similarly, a multicenter, retrospective trial in Austria evaluating dalbavancin for osteomyelitis, prosthetic joint infection, endocarditis, and skin and soft-tissue infections found a clinical success rate of 89% with minimal adverse effects [11].Finally, a German study evaluating potential cost savings of single-dose dalbavancin estimated that dalbavancin saved 6.45 hospital days and EUR 2865 in patients with MRSA skin and soft-tissue infection and 10.6 hospital days and EUR 3909 in patients with MRSA bone and joint infections [12].…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Use of Dalbavancin for Off-Label Indications

Taylor

Williamson

Luther

et al. 2022

Infectious Disease Reports

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(1) Background: Dalbavancin is a long-acting lipoglycopeptide antibiotic approved for skin and soft-tissue infections. Post-marketing experience suggests dalbavancin is being used for off-label indications that normally require long-term intravenous (IV) antibiotics; however, data assessing this off-label usage are limited. The purpose of this study was to evaluate the real-world efficacy, safety, and financial impact of off-label dalbavancin use. (2) Methods: This is a retrospective, observational study conducted within a 4-hospital health system. Adult patients who received dalbavancin from January 2018 to January 2021 for an off-label indication were included. The primary outcome was clinical success at 90 days. Secondary outcomes included safety (nephrotoxicity and hepatotoxicity). A pharmacoeconomic analysis was performed by comparing the cost of dalbavancin to the anticipated cost of patient stay if standard IV therapy was given. (3) Results: Forty-eight patients met study criteria. Indications included osteomyelitis (54%), endocarditis (23%), bacteremia (15%), and prosthetic joint infection (8%). The predominant organism was S. aureus (60%), with 42% caused by methicillin-resistant S. aureus. Overall, 41 (85%) patients achieved clinical success at 90 days, including 85% with osteomyelitis, 82% with endocarditis, and 86% with bacteremia. There were no instances of nephrotoxicity or hepatotoxicity. Estimated cost avoidance per patient was USD 5313 and USD 1683 if traditional IV therapy would have been completed in the hospital and skilled nursing facility, respectively. (4) Conclusion: Dalbavancin was associated with a relatively high success rate for the treatment of off-label indications and may be a cost-effective alternative to traditional IV antibiotic therapy.

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Section: Discussionmentioning

confidence: 99%

Evaluating the Use of Dalbavancin for Off-Label Indications

Taylor

Williamson

Luther

et al. 2022

Infectious Disease Reports

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“…2.8 million SHI insured individuals and can provide longitudinal information, such as 30- and 90 day mortality and has frequently been used in analyses [ 12 , 13 ]. The BM-DB is a database used for hospital benchmarking purposes and contains data from 300 hospitals with more than 4 million inpatient episodes and has also been the basis for claims data-based analyses [ 14 ]. Both databases provide anonymized patient-level data of all diagnoses, procedures that have been coded during a hospital stay.…”

Section: Methodsmentioning

confidence: 99%

Carbapenem-resistant gram-negative bacteria in Germany: incidence and distribution among specific infections and mortality: an epidemiological analysis using real-world data

Wilke

Preisendörfer²,

Seiffert³

et al. 2022

Infection

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Purpose Infections with carbapenem-resistant gram-negative bacteria (in Germany classified as 4MRGN) are a growing threat in clinical care. This study was undertaken to understand the overall burden of 4MRGN infections in Germany in the context of a Health Technology Appraisal (HTA) for Ceftazidime/Avibactam (CAZ/AVI). Besides, the incidences mortality was an endpoint of interest. Methods To assess infections with carbapenem-resistant gram-negative bacteria and related mortality, three different data sources have been used. From the German statistics office (DESTATIS) data have been retrieved to obtain the overall frequency these pathogens. Via two other databases, the German analysis database (DADB) and a Benchmarking of > 200 hospitals in a representative sample (BM-DB), the distribution of the infections and the mortality have been analyzed. Results DESTATIS data showed a total of 11,863 carbapenem-resistant gram-negative bacteria codings, of which 10,348 represent infections and 1515 carriers. The most frequent infections were complicated urinary tract infections (cUTI) (n = 2,337), followed by pneumonia (n = 1006) and intra-abdominal infections (n = 730). A considerable amount of patients had multiple infections in one hospital episode (n = 1258). In-hospital mortality was 18.6% in DADB and 14.3% in the BM-DB population, respectively. In cases with additional bloodstream infections, DADB mortality was correspondingly higher at 33.0%. DADB data showed an incremental mortality increase of 5.7% after 30 days and 10.0% after 90 days resulting in a cumulative 90 day mortality of 34.3%. Conclusions Infections with carbapenem-resistant gram-negative bacteria are still rare (6.8–12.4 per 100,000) but show a significant increase in mortality compared to infections with more sensitive pathogens. Using different data sources allowed obtaining a realistic picture.

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“…Several studies have evaluated the cost-effectiveness of dalbavancin compared to other treatment options for various infections [39][40][41]. BJI correlates with a protracted hospital stay.…”

Section: Pharmacoeconomic Characteristicsmentioning

confidence: 99%

“…On the other hand, early initiation of dalbavancin therapy has been associated with reduced costs due to its potent and rapid bactericidal effects, which may shorten the length of hospital stay [5]. Dalbavancin's once-weekly dosing regimen allows for OPAT, reducing the burden on healthcare facilities and potentially minimizing overall treatment costs [41]. In a single study, patients with BJI could be discharged 10.6 days earlier, and EUR 3909 could be saved [41].…”

Section: Pharmacoeconomic Characteristicsmentioning

confidence: 99%

“…Dalbavancin's once-weekly dosing regimen allows for OPAT, reducing the burden on healthcare facilities and potentially minimizing overall treatment costs [41]. In a single study, patients with BJI could be discharged 10.6 days earlier, and EUR 3909 could be saved [41]. Another study compared long-acting lipoglycopeptides (LaLGP) with the standard-of-care and showed that the average total healthcare-related cost of care was USD 295,589 in the LaLGP compared to USD 326,089 in the standard-of-care cohort [40].…”

Section: Pharmacoeconomic Characteristicsmentioning

confidence: 99%

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A Narrative Review on the Role of Dalbavancin in the Treatment of Bone and Joint Infections

Dimopoulou,

Mantadakis,

Koutserimpas

et al. 2023

Antibiotics

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Bone and joint infections (BJI) require prolonged antimicrobial treatment, leading to lengthy hospitalizations, high costs, the risk of nosocomial infections, and the development of antimicrobial resistance. Dalbavancin is a novel semisynthetic lipoglycopeptide approved for the treatment of adults and children with acute bacterial skin and skin structure infections. This narrative review aims to summarize the characteristics of dalbavancin and the current scientific evidence regarding its clinical efficacy and safety in the treatment of BJI. A literature search until June 2023 was performed to identify all published research about the role of dalbavancin in the management of BJI. Due to its unique pharmacokinetics characterized by prolonged half-life, high bactericidal activity against most Gram-positive bacteria, a good safety profile, and high tissue penetration, dalbavancin can be a valuable alternative to the treatment of BJI. Clinical studies have shown its non-inferiority compared to conventional therapies in BJI, offering potent activity against key pathogens and an extended dosing interval that may shorten hospitalization. In conclusion, dalbavancin represents a promising treatment option for BJI with a favorable safety profile, but further research in both adults and particularly children, who are ideal candidates for long-acting antibiotics, is necessary to evaluate the role of dalbavancin in BJI.

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Potential savings through single-dose intravenous Dalbavancin in long-term MRSA infection treatment – a health economic analysis using German DRG data

Cited by 6 publications

References 41 publications

Evaluating the Use of Dalbavancin for Off-Label Indications

Evaluating the Use of Dalbavancin for Off-Label Indications

Carbapenem-resistant gram-negative bacteria in Germany: incidence and distribution among specific infections and mortality: an epidemiological analysis using real-world data

A Narrative Review on the Role of Dalbavancin in the Treatment of Bone and Joint Infections

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