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Dalbavancin – Greater Cost, Lower Success?

November 11, 2021

Written By Gabby Leonard

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Single-dose dalbavancin treatment for skin and soft tissue infections came at a higher cost and higher risk of failure than conventional therapy.

Why does this matter?
Patients are typically eager to avoid hospitalization. A single-dose IV antibiotic for skin and soft tissue infection offers flexibility to treatment plans and the potential for monitoring at home. But these long-acting drugs come at a high cost, with potential risk for recurrent infection. How did dalbavancin perform in this study?

Is treat and street better?
This was a multi-center retrospective study that evaluated the net cost of care per patient over a 27 month period for adults diagnosed with acute bacterial skin and skin structure infections (ABSSI) treated either with dalbavancin or standard of care treatment.

Treatment with dalbavancin had a higher net cost for the hospital (revenue minus total cost) of $1685 per patient compared with $75 in patients who received standard of care. Additionally, treatment success rate (defined as no 30-day hospital readmission) was lower in those who received dalbavancin (74%) vs standard of care (85%), p=0.004.

While dalbavancin may be used as a single-dose IV antibiotic to treat patients with moderate to severe skin and soft tissue infections to reduce initial hospitalization rates, it had a higher overall net cost and a lower treatment success rate in this cohort when compared with standard of care treatment. Additionally, patients with high risk conditions, such as being immunocompromised, using IV drugs, and having antibiotic-resistant infections may have an even higher risk of failing treatment with dalbavancin and requiring hospital readmission. However, there are specific populations in which dalbavancin can be considered, such as patients who may have difficulty with medication adherence or medical literacy regarding dosing and duration of treatment.

Source
Cost-Consequence Analysis of Single-Dose Dalbavancin Versus Standard of Care for the Treatment of Acute Bacterial Skin and Skin Structure Infections in a Multisite Healthcare System. Clin Infect Dis. 2021 Oct 5;73(7):e1436-e1442. doi: 10.1093/cid/ciaa1732.

Reviewed by Clay Smith

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