It is estimated that acute bacterial skin and skin structure infections (ABSSSI) account for about 10% of hospital admissions in the US. Analyses of hospital claims indicate 74% of ABSSSI admissions involve empiric treatment with methicillin-resistant Staphylococcus aureus (MRSA) active antibiotics. Hospitalization costs could be reduced if moderate-severe ABSSSI patients were treated to a greater extent in the observational unit followed by discharge to outpatient parenteral antibiotic therapy (OPAT). Oritavancin is a novel single-dose regimen, intravenous lipoglycopeptide antibiotic for ABSSSIs caused by gram-positive bacteria, including MRSA. The aim of our analysis was to quantify the economic value of using oritavancin for ABSSSI patients at risk of MRSA from a US hospital perspective.

A decision analytic model based on current clinical practice was developed to estimate the economic value of decreased hospital resources by using oritavancin. Utilization of antibiotics was informed by analysis of the Premier hospital database. Demographic and clinical data were derived from a targeted literature review. ER, observation, laboratory, administration costs were from Medicare National Limitation amounts. Drug costs were 2014 wholesale acquisition costs. To estimate the economic impact of reducing resources using oritavancin we set its price to $0.

For a hypothetical US hospital treating 1,000 ABSSSI patients eligible for IV MRSA antibiotics/year, the administration of oritavancin in 25.75% of patients facilitates shifting patients to the OPAT setting (441 to 561 patients) with a total annual economic impact of $2,752K. Inpatient and outpatient costs were reduced by $2,543K and $209K, respectively. Inpatient cost savings were derived from a reduction in hospitalizations and lower administration burden drove decreased OPAT costs.

Using oritavancin in moderate-severe ABSSSI patients, including those at risk of MRSA, is estimated to deliver an estimated cost reduction of $2,752/patient by shifting patient care to the OPAT setting, and decreasing resource utilization.