Cost-effectiveness of linezolid versus vancomycin for hospitalized patients with complicated skin and soft-tissue infections in France.
Studies have shown similar clinical cure rates and shorter length of hospitalization when using linezolid compared to vancomycin in patients with complicated skin and soft-tissue infections due to suspected or proven methicillin-resistant Staphylococcus aureus (MRSA).


OBJECTIVE
This study had for aim to compare the cost-effectiveness of linezolid versus vancomycin in French healthcare settings.


METHODS
A decision-analytic model followed an average patient from the initiation of an empiric treatment until cure, death or second-line treatment failure. A clinical data probability was obtained from clinical trials, resource utilization data (including treatment duration and length of hospitalization) and prevalence of MRSA was obtained from a Delphi panel, and costs from published sources.


RESULTS
First-line cure rate for linezolid-treated patients was 90.7% versus 85.5% for vancomycin; the total cure rates after two lines of treatment were 98.5% and 98.0%, respectively. The average total cost was 7,778euro for linezolid versus 8,777euro for vancomycin. The mean estimated length of hospitalization after two lines of treatment was 10.7 days for linezolid versus 13.3 days for vancomycin. The increased effectiveness and reduced cost lead to more frequent prescription. This did not change after one-way sensitivity analyses.


CONCLUSIONS
Linezolid may be considered as a cost-effective treatment for patients with complicated skin and soft-tissue infections suspected to be MRSA related in France.
De Cock
E
E
United BioSource Corporation, Health Care Analytics Group, Carrer Torrent del Remei 5-11, 4 degrees -2 feminine, Barcelona 08023, Spain.
Sorensen
S
S
Levrat
F
F
Besnier
J-M
JM
Dupon
M
M
Guery
B
B
Duttagupta
S
S
D000081:Acetamides / Q000191:economics / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000191:economics / Q000627:therapeutic use*; D003663:Decision Trees; D016903:Drug Monitoring / Q000379:methods / Q000592:standards; D005602:France; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000191:economics; D006801:Humans; D007297:Inpatients; D000069349:Linezolid; D055624:Methicillin-Resistant Staphylococcus aureus; D023303:Oxazolidinones / Q000191:economics / Q000627:therapeutic use*; D012874:Skin Diseases, Infectious / Q000188:drug therapy*; D018461:Soft Tissue Infections / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000191:economics; D013207:Staphylococcal Skin Infections / Q000188:drug therapy* / Q000191:economics
D000081:Acetamides; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D000069349:Linezolid