OBJECTIVES

To estimate potential cost-savings associated with the use of oritavancin for moderate-to-severe ABSSSI patients from a large US academic hospital perspective.

METHODS

A budget impact model (BIM) was developed to evaluate the economic impact of the introduction of single dose oritavancin in outpatient setting compared to the inpatient standard of care for ABSSSI patients. We reviewed medical records of ABSSSI patients admitted to the University of Florida Health Shands Hospital (Gainesville, FL) between Jan to Dec 2015 to identify ‘oritavancin eligible’ patients as following: a) >= 18 years, b) received at least 24 hours of antimicrobials, c) class II or III as per CREST+ SEWS classification, d) had an early cure at 48 hours, and e) no acute exacerbation of another disease. Cost components including laboratory, radiology, drugs, room and board from hospital discharge data were analyzed. Total healthcare costs including pharmacy and medical costs were compared between the two alternatives.

RESULTS

Of 531 ABSSSI patients, 98 were identified as oritavancin candidates. The mean age of these patients was 50.6 ± 17.2 years and mean length of stay was 3.0 days. The total cost of treatment was $389,010 (or $3,969/patient) with $26,380 for drugs and $330,425 for room and board with the standard inpatient therapy. The BIM estimated a total cost of $308,934 (or $3,152/patient) with outpatient oritavancin use. Savings were driven by cost reductions in room and board ($15, 752) although drug cost is much higher ($264,688). The estimated cost savings from standard inpatient therapy to outpatient oritavancin use was $80,075 for 98 patients (or $817 per patient).

CONCLUSIONS

Use of oritavancin led to cost-savings of $817 per patient compared to the standard care by shifting treatment to outpatient settings. High costs of oritavancin were offset by a greater reduction in costs due to hospital inpatient stays.