Pharmacoeconomic Analysis Of Dalbavancin Use In Acute Bacterial Skin And Soft Tissue Infections

Dalbavancin is a new generation anti-infective agent; it was licensed in the US in 2014 and in the EU in 2015 for the treatment of acute bacterial skin and soft tissue infections (ABSSTI) caused by gram-positive microorganisms. The purpose of this study is to perform a pharmacoeconomic comparison of the use of dalbavancin versus vancomycin and dalbavancin versus vancomycin-oral linezolid for the treatment of ABSSTI due to gram-positive microorganisms in Turkey and in the US. A decision tree model has been designed from the perspective of reimbursement institutions. Efficacy and safety data were obtained through clinical trials in the published studies and costs were obtained by the prices announced by the reimbursement institution, and the literature. The primary outcome was the incremental cost-effectiveness ratio, expressed as ₺ and $ per successfully treated patient. The cost-effectiveness ratios for dalbavancin and vancomycin were ₺5,489 and ₺1,375 respectively, in Turkey, while the cost-effectiveness ratios were $13,911 and $9,112 per successfully treated patients, respectively, in the US. Due to the fact that dalbavancin is licensed and already priced in the US, the threshold analysis was performed over the hospitalization days in that context. In order for dalbavancin to be cost-effective in US, patients should be hospitalized less than 0,62 days. The model was not sensitive to the hospitalization duration and the hospital costs in Turkey. The model was sensitive to the hospitalization duration in the US. Vancomycin was more cost-effective compared to dalbavancin in Turkey, whereas vancomycin-linezolid was more cost-effective compared to dalbavancin in the US in treating ABSSTI. Thus in countries such as the US where hospital costs are high, dalbavancin may be a cost effective alternative for patients who are eligible for outpatient treatment. Furthermore, the use of dalbavancin in Turkey may be beneficial in reducing the intensity of care in hospitals.