title: Cost-effectiveness of linezolid versus vancomycin for hospitalised patients with complicated skin and soft-tissue infections in Germany.
abstract: This study used a decision analytic model approach to evaluate the cost-effectiveness of linezolid versus vancomycin in the empirical treatment of complicated skin and soft-tissue infection (cSSTI) due to suspected methicillin-resistant Staphylococcus aureus (MRSA) from the German hospital and health care system perspective. Clinical probabilities were obtained from trial data, resource utilisation and MRSA prevalence rates were obtained through German physician interviews, and costs from published sources were applied to resource units. Outcomes included total cost/patient and cure. The estimated first-line cure rate for linezolid-treated patients was 90.1% versus 85.5% for vancomycin; total cure rates after two lines of treatment were 98.4% and 98.1%, respectively. Average total cost/episode was 8,232 euro for linezolid versus 9,206 euro for vancomycin. The model outcomes were sensitive to changes in length of stay (LOS), isolation days, rate of confirmed MRSA and price of linezolid. Linezolid was expected to result in a shorter intravenous treatment duration and shorter LOS that offset its higher acquisition cost versus vancomycin in cSSTI in Germany.
authors.affiliation: Department of Internal Medicine, Charité, Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Schürmann
authors.forename: Sonja V
authors.initials: SV
authors.lastname: Sorensen
authors.forename: Erwin
authors.initials: E
authors.lastname: De Cock
authors.forename: Sandeep
authors.initials: S
authors.lastname: Duttagupta
authors.forename: Ansgar
authors.initials: A
authors.lastname: Resch
mesh_terms: D000081:Acetamides / Q000191:economics* / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D003697:Delphi Technique; D005858:Germany; D006801:Humans; D000069349:Linezolid; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D023303:Oxazolidinones / Q000191:economics* / Q000627:therapeutic use; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000191:economics*; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000191:economics*; D014640:Vancomycin / Q000191:economics* / Q000627:therapeutic use
chemical_list: D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D014640:Vancomycin; D000069349:Linezolid