some more COST data... 75% of ABSSSI costs inpatients -- so B at 1-dose will save $$$ also, a study on MRSA market, MD Rx behavior, Vanco still preferred
PIN 58 Direct Medical Costs and Health Care Resource Utilization Associated with Selected Antibiotic Pahtways in ABSSSI Infections in the U.S. [The Medicines Company was a sponsor] PIN 58 Objectives: Current guidelines for the treatment of acute bacterial skin and skin structure infections (ABSSSI) recommend several treatment pathways based on the infection types and severity. The objective of this study is to establish the health care resource utilization (HRU) and costs associated with the most common patient treatment pathways in US. Methods:The medical and pharmacy administrative claims of adult ABSSSI patients with continuous commercial or Medicare Advantage enrollment with Part D prescription drug coverage between 01 January 2009 and 31 December 2011 were extracted from a large national health plan affiliated with OptumInsight. The four most common treatment pathways were identified based on the evidences of antibiotics over the entire ABSSSI treatment course. All four path - ways start with vancomycin IV use during a hospital stay. At discharge, patients followed one of four pathways: 1) continue IV vancomycin as an Outpatient Parenteral Antibiotic Therapy (OPAT); 2) switch to oral linezolid; 3) switch to daptomycin; or 4) switch to any oral antibiotic other than linezolid, clindamycin, or TMP-SMX. Health care resource utilization and costs were determined for each pathway. Results:A total of 1418 patients met all of inclusion/exclusion criteria. The majority of patients either continued Vancomycin IV (46.5%) or switched to oral linezolid (41.4%) at discharge. Only about 12% of patients were switched to Daptomycin or other non-MRSA active oral antibiotics. The average ABSSSI-related total health care cost was $16,571 for the entire ABSSSI treatment. Total costs were comprised of $12,519 (75.5%) for inpatient cost, $201 (1.2%) for emergency department (ED) visits, $879 (5.3%) for outpatient treatment/office visits, and $1,015(6.1%) for pharmacy claims cost. The costs overall and in various locations of care varied by pathway. Conclusions: Inpatient treatment remains the largest component of total ABSSSI treatment cost. Utilization of linezolid and daptomycin increased the pharmacy or OPAT costs
Despite Generic Vancomycin’s Continued Dominance of the MRSA Market, Branded Agents Cubicin and Zyvox Emerge as Preferred Agents Among Surveyed Physicians
Emerging Therapies Will Need to Demonstrate Improvements Over Standard-of-Care to Justify Premium Pricing, According to Findings from Decision Resources Group May 6, 2014 – Burlington, Mass. – Decision Resources Group finds that overall, infectious disease (ID) specialists and non-ID physicians (critical care and internal medicine specialists) prefer the branded agents Cubist’s Cubicin (daptomycin) and Pfizer’s Zyvox (linezolid), respectively, when treating methicillin-resistant Staphylococcus aureus (MRSA) infections in the hospital. Nearly half of surveyed ID specialists indicate they prefer Cubicin for treatment of bloodstream infections and/or endocarditis due to MRSA, whereas less than 20 percent of non-ID specialists indicate preference for Cubicin in these indications. However, both physician groups prefer Zyvox for nosocomial pneumonia due to MRSA, likely driven by post-marketing studies demonstrating its clinical superiority over vancomycin. Despite varying drug preferences between the two physician groups, vancomycin remains their most prescribed antibiotic for MRSA infections by both ID specialists and non-ID physicians, driven by physician familiarity, unrestricted formulary access and lower cost.
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