title: Use of Oritavancin in Acute Bacterial Skin and Skin Structure Infections Patients Receiving Intravenous Antibiotics: A US Hospital Budget Impact Analysis.
abstract: OBJECTIVE
  Nearly 10% of all US hospital admissions are attributed to acute bacterial skin and skin structure infections (ABSSSIs). While most antibacterials used to treat these infections require multi-day and multi-dose regimens, a single-dose treatment is now available. The objective of this analysis is to estimate the annual budget impact of using single-dose oritavancin in patients with moderate to severe ABSSSIs receiving intravenous methicillin-resistant Staphylococcus aureus (MRSA)-active antibacterials from a US hospital perspective.
  
  
  METHODS
  A decision-analytic model based on current clinical practice was developed to estimate the economic impact of oritavancin. Utilization of antibacterials and rates of hospital admission were derived from the Premier Research Database. Demographic and clinical data were informed by the published literature and 2014 wholesale drug acquisition costs were used. Other costs were based on the published literature and Medicare National Limitation amounts. All costs were inflated to 2014 US dollars. Two base-case scenarios were considered: one for hospitals with ambulatory services and one for hospitals without ambulatory services.
  
  
  RESULTS
  For a US hospital with ambulatory services with 1000 ABSSSI patients receiving intravenous MRSA antibiotics annually, use of oritavancin in 26% of patients is estimated to reduce the total annual budget by 12.9% (US$1.23 million), or approximately US$1234.67 per patient. Total inpatient costs will be reduced by 22.3% (US$1.40 million) and outpatient costs will increase slightly by 1.7% (US$55,310). Pharmaceutical cost increases are offset by savings in the inpatient setting from fewer hospital admissions. Hospitals without ambulatory services are estimated to receive overall cost savings of 9.3% (US$0.63 million).
  
  
  CONCLUSIONS
  Use of single-dose oritavancin in select ABSSSI patients with suspected or confirmed MRSA involvement is estimated to save US hospitals approximately 9.3-12.9% per year by reducing hospital admissions and lowering drug administration burden.
authors.affiliation: ICON Health Economics, Cambridge, MA, USA.
authors.forename: Ivar S
authors.initials: IS
authors.lastname: Jensen
authors.affiliation: Albany College of Pharmacy and Health Sciences, Albany, NY, USA.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Lodise
authors.affiliation: The Medicines Company, 8 Sylvan Way, Parsippany, NJ, USA.
authors.forename: Weihong
authors.initials: W
authors.lastname: Fan
authors.affiliation: ICON Health Economics, Cambridge, MA, USA.
authors.forename: Chining
authors.initials: C
authors.lastname: Wu
authors.affiliation: ICON Health Economics, Cambridge, MA, USA.
authors.forename: Philip L
authors.initials: PL
authors.lastname: Cyr
authors.affiliation: Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT, USA.
authors.forename: David P
authors.initials: DP
authors.lastname: Nicolau
authors.affiliation: Pharmaceutical Services and Ambulatory Infusion Center, Beaumont Health System, Troy, MI, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: DuFour
authors.affiliation: The Medicines Company, 8 Sylvan Way, Parsippany, NJ, USA. kate.sulham@themedco.com.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Sulham
mesh_terms: D000208:Acute Disease; D061605:Administration, Intravenous; D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D003661:Decision Support Techniques; D016527:Drug Costs; D004469:Economics, Hospital; D005260:Female; D006020:Glycopeptides / Q000191:economics* / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D000077427:Lipoglycopeptides; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D018803:Models, Economic; D017192:Skin Diseases, Bacterial / Q000188:drug therapy / Q000191:economics*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000191:economics*; D014640:Vancomycin / Q000031:analogs & derivatives
chemical_list: D000900:Anti-Bacterial Agents; D006020:Glycopeptides; D000077427:Lipoglycopeptides; C100708:oritavancin; D014640:Vancomycin