PROJECTING CHANGES IN TOTAL DAYS OF THERAPY (DOT) IN PATIENTS HOSPITALIZED FOR ACUTE BACTERIAL SKIN AND SKIN STRUCTURE INFECTION (ABSSSI)

Author(s)

Berger A1, Kauf T2, Oster G3
1Evidera, Lexington, MA, USA, 2Cubist Pharmaceuticals, Lexington, MA, USA, 3Policy Analysis Inc. (PAI) and Managing Co-Director, MINERVA Health Economics Network, Brookline, MA, USA

OBJECTIVES: Most patients admitted to hospital for ABSSSI complete antibacterial treatment following discharge.  This study examined the potential impact of tedizolid versus linezolid on antibacterial DOT, based on real-world inpatient use of linezolid in patients hospitalized for ABSSSI, and two pivotal phase 3 studies of patients with ABSSSI that demonstrated comparable efficacy and safety between a 6-day course of tedizolid (once daily) and a 10-day course of linezolid (twice daily).  METHODS: Duration of in-hospital therapy for ABSSSI was based on analyses of an electronic database containing comprehensive clinical records on ~38 million inpatient admissions from >100 contributing general, acute-care US hospitals.  All patients aged ≥18 years admitted during 2011 with a principal diagnosis consistent with ABSSSI who received ≤10 inpatient DOT with linezolid were identified.  Total DOT for linezolid and tedizolid (i.e., inpatient + outpatient) were assumed to be 10 and 6 days, respectively.  Patients receiving <10 days of in-hospital therapy with linezolid were assumed to receive the remainder as outpatients; corresponding values for tedizolid were estimated assuming a 6-day DOT.  Patients receiving ≤6 inpatient DOT with linezolid were modeled to receive the same number of inpatient days of tedizolid; patients with >6 days of in-hospital therapy with linezolid were modeled as completing a course of tedizolid in hospital.  RESULTS: Among the 3,734 ABSSSI patients who met study entry criteria, 153 (4%) received linezolid.  Mean inpatient DOT was 3.7 days; consequently, expected duration of outpatient therapy was 6.3 days.  Use of tedizolid instead of linezolid was estimated to reduce average inpatient DOT by 0.2 days and outpatient DOT by 3.8 days.  CONCLUSIONS: Based on real-world use of linezolid for ABSSSI and findings from tedizolid pivotal trials, use of tedizolid in hospitalized patients with ABSSSI may substantially reduce mean total DOT compared with linezolid, primarily on an outpatient basis.

Conference/Value in Health Info

2015-05, ISPOR 2015, Philadelphia, PA, USA

Value in Health, Vol. 18, No. 3 (May 2015)

Code

PIN94

Topic

Health Service Delivery & Process of Care

Topic Subcategory

Prescribing Behavior

Disease

Infectious Disease (non-vaccine), Sensory System Disorders

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