OBJECTIVES: Due to its posology, treatment with dalbavancin, a long-acting IV lipoglycopeptide, can reduce the hospital length of stay (LoS) of patients with acute bacterial skin and skin structure infections (ABSSSIs). We aimed to assess the economic impact for the Spanish National Health System (NHS) associated with the management of ABSSSIs treated in hospitals with long-acting dalbavancin versus other glycopeptide antibiotics.

METHODS: A cost analysis has been developed from Spanish NHS perspective, comparing the use of long-acting dalbavancin (1500 mg, 30-minute IV infusion) versus vancomycin and teicoplanin in ABSSSIs for a 3-year time horizon. The posology of the treatments was obtained from the corresponding summaries of product characteristics, and 14 days of treatment and hospital LoS was considered. Direct healthcare costs (drug cost and hospitalization costs, € of 2022) were considered. The reduction in hospital LoS for dalbavancin versus glycopeptides was calculated according to various published articles. Target population was obtained from the Spanish National Hospital Discharge Database (CIE10: L08). The current market distribution between dalbavancin, vancomycin and teicoplanin was established based on internal data. A potential scenario was explored where the market share of dalbavancin increases by 5%, 10% and 15% for the first, second and third year of the analysis, respectively.

RESULTS: The increase in dalbavancin's market share would be associated with potential savings due to shorter LoS. So, the higher pharmacological cost of dalbavancin versus vancomycin/teicoplanin is fully offset by a lower cost of hospital stay, with overall savings of €152,268, €309,632, and €470,320 for years 1 to 3, respectively.

CONCLUSIONS: The results of the analysis show that the increased use of dalbavancin is associated with potential savings for the NHS in the treatment of ABSSSIs, due to the reduction in hospital LoS, when compared to other glycopeptide antibiotics such as vancomycin and teicoplanin.