OBJECTIVES: Due to its unique posology in the pediatric population, 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 pediatric ABSSSIs treated in hospitals with dalbavancin versus vancomycin and daptomycin.

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 daptomycin in ABSSSIs for a 3-year time horizon. The posology of the treatments was obtained from the corresponding summaries of product characteristics, accounting for weighted average weight in the pediatric population, and 14 days of treatment and hospital LoS were considered. Direct healthcare costs (drug cost and hospitalization costs, € of 2023) were considered. The reduction in hospital LoS was calculated according to various published articles. Pediatric target population was obtained from the Spanish National Hospital Discharge Database (CIE10: L08). The current market distribution was 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/daptomycin is fully offset by a lower cost of hospital stay, with overall savings of €10,698, €22,680, and €34,662 for years 1 to 3, respectively.

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