Potential Cost-Savings with Once-Daily Aminomethylcycline Antibiotic versus Vancomycin in Hospitalized Patients with Acute Bacterial Skin and Skin Structure Infections.

Simple item page
dc.contributor.authorLaPensee, Kenneth
dc.contributor.authorLodise, Thomas P
dc.contributor.orcidhttps://orcid.org/0000-0002-4730-0655
dc.date.accessioned2025-02-11T19:49:21Z
dc.date.available2025-02-11T19:49:21Z
dc.date.issued2018-12
dc.description.abstractBackground: Omadacycline is an oral and intravenous (IV) once-daily aminomethylcycline antibiotic that was recently approved by the US Food and Drug Administration for the treatment of patients with acute bacterial skin and skin structure infections (ABSSSI). In 2 phase 3 clinical trials, IV-to-oral switch and oral-only administration of omadacycline achieved the primary end points of noninferiority compared with linezolid in treating patients with ABSSSI. Objective: To estimate the potential cost-savings with bioequivalent IV-to-oral antibiotics, such as omadacycline, compared with the standard of care with IV vancomycin by avoiding hospitalizations and reducing hospital stays in patients presenting from the emergency department for ABSSSI treatment. Methods: We used hospital avoidance models to examine the potential cost-savings of managing patients with ABSSSI and no or limited comorbidities and without life-threatening conditions by using omadacycline in the outpatient setting compared with the current standard of care. Early hospital discharge models were used to evaluate the hospital stay reduction that would be required to be achieved with omadacycline treatment relative to IV vancomycin to confer cost-savings compared with standard of care among patients with ABSSSI and >/=2 comorbidities but no life-threatening conditions. Results: In the hospital stay avoidance models, cost-savings may be realized by using therapeutically bioequivalent IV-to-oral antibiotics, such as omadacycline, compared with inpatient treatment with IV vancomycin. Based on a sensitivity analysis, further savings could be possible with outpatient administration of omadacycline, even if 20% of omadacycline outpatients were subsequently admitted and incurred the full inpatient cost, with no reimbursement penalties. Of more than 300 patients, only 1 was admitted to the hospital after a full course of omadacycline in the oral-only clinical trial. In the early hospital discharge models, the maximum cost-minimizing daily expense of omadacycline varied from $173 to $936, depending on the presence of active comorbidities or systemic symptoms, hospital stay reduction, and model perspective. Conclusion: These results suggest that the targeted use of antibiotics with bioequivalent IV-to-oral formulations, such as omadacycline, for select patients with ABSSSI may lead to cost-savings compared with inpatient IV vancomycin treatment by shifting care to the outpatient setting or by facilitating earlier hospital discharge among hospitalized patients.
dc.description.urihttp://www.ncbi.nlm.nih.gov/pmc/articles/pmc6322591
dc.identifier.citationLaPensee K, Lodise T. Potential Cost-Savings with Once-Daily Aminomethylcycline Antibiotic versus Vancomycin in Hospitalized Patients with Acute Bacterial Skin and Skin Structure Infections. Am Health Drug Benefits. 2018 Dec;11(9):449-459. PMID: 30746017; PMCID: PMC6322591.
dc.identifier.issn1942-2962
dc.identifier.other30746017
dc.identifier.urihttps://hdl.handle.net/20.500.14303/844
dc.language.isoen
dc.publisherEngage Healthcare Communications
dc.relation.ispartofAmerican Health & Drug Benefits
dc.rightsThis Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). http://rightsstatements.org/vocab/InC/1.0/
dc.subjectacute bacterial skin and skin structure
dc.subjectaminomethylcycline
dc.subjectantibiotics
dc.subjectcost-savings
dc.subjecteconomic modeling
dc.subjecthospital stay
dc.subjecthospitalized patients
dc.subjectinfections
dc.subjectinpatient cost
dc.subjectintravenous
dc.subjectomadacycline
dc.subjectoutpatient cost
dc.subjectskin infections
dc.subjectvancomycin
dc.titlePotential Cost-Savings with Once-Daily Aminomethylcycline Antibiotic versus Vancomycin in Hospitalized Patients with Acute Bacterial Skin and Skin Structure Infections.
dc.typeArticle
local.departmentprogramDepartment of Pharmacy Practice
Files
Collections
Lodise, Thomas P. Publications