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Cost‐Effectiveness of Telavancin versus Vancomycin for Treatment of Complicated Skin and Skin Structure Infections
Author(s) -
Laohavaleeson Somvadee,
Barriere Steven L.,
Nicolau David P.,
Kuti Joseph L.
Publication year - 2008
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.28.12.1471
Subject(s) - vancomycin , medicine , interquartile range , methicillin resistant staphylococcus aureus , population , surgery , staphylococcus aureus , environmental health , biology , bacteria , genetics
Study Objective. To determine the cost‐effectiveness of telavancin versus vancomycin for the treatment of complicated skin and skin structure infections (cSSSIs). Design. Pharmacoeconomic analysis conducted from the hospital's perspective using data from the Assessment of Telavancin in Complicated Skin and Skin Structure Infections (ATLAS) phase III clinical trial. Setting. One hundred twenty‐nine hospitals in the United States and internationally. Patients. A total of 1044 clinically evaluable patients who were hospitalized with a cSSSI during the ATLAS trial and who received at least one dose of telavancin or vancomycin in the hospital. Measurements and Main Results. Diagnosis‐related group‐specific hospital bed costs, antibiotic acquisition prices, and cost of vancomycin monitoring were applied to the resource utilization data collected during the ATLAS trial. Infection‐related length of stay (LOS IR ) and hospitalization costs (COST IR ) were compared between the telavancin (514 patients) and vancomycin (530 patients) groups. Incremental cost‐effectiveness ratios (ICERs) were calculated for the total population and a subset of patients infected with methicillin‐resistant Staphylococcus aureus (MRSA) by using a 25,000‐sample bootstrap analysis. During sensitivity analyses, the daily acquisition price for telavancin was increased from the equivalent to vancomycin ($13.44) to $50, $100, $150, or $200, and the rate of MRSA acquisition was varied between 30% and 75%. The median (interquartile range) LOS IR was 8 days (6–12 days) for both telavancin and vancomycin (p=0.742), and median (interquartile range) COST IR was $8118 ($6291‐11,758) and $8185 ($6474‐11,405), respectively (p=0.560). Similar findings were observed for the MRSA subset. Telavancin cost‐effectiveness was greater for the MRSA population versus the total population. During bootstrap analyses of the MRSA population, the ICER for telavancin ranged from dominant (‐$9560) to $27,889 as acquisition price was increased. Conclusions. Telavancin LOS IR and total COST IR were similar to those of vancomycin for the treatment of cSSSIs. Particularly in those infected with MRSA, telavancin may be more cost‐effective than vancomycin over the range of acquisition prices tested.