Department of Pharmacy, Memorial Hospital West, Pembroke Pines, Florida, USA.
Office of Human Research, Memorial Healthcare System, Hollywood, Florida, USA.
Clin Infect Dis. 2021 Oct 5;73(7):e1436-e1442. doi: 10.1093/cid/ciaa1732.
Acute bacterial skin and skin structure infections (ABSSSIs) are common infectious diseases that cause a significant economic burden on the healthcare system. This study aimed to compare the cost-effectiveness of dalbavancin vs standard of care (SoC) in the treatment of ABSSSI in a community-based healthcare system.
This was a retrospective study of adult patients with ABSSSI treated with dalbavancin or SoC during a 27-month period. Patients were matched based on age and body mass index. The primary outcome was average net cost of care to the healthcare system per patient, calculated as the difference between reimbursement payments and the total cost to provide care to the patient. The secondary outcome was proportion of cases successfully treated, defined as no ABSSSI-related readmission within 30 days after the initiation of treatment.
Of the 418 matched patients, 209 received SoC and 209 received dalbavancin. The average total cost of care per patient was greater with dalbavancin vs SoC ($4770 vs $2709, P < .0001). The average reimbursement per patient was $3084 with dalbavancin vs $2633 SoC (P = .527). The net cost, calculated as revenue minus total cost, was $1685 with dalbavancin vs $75 with SoC (P = .013). The overall treatment success rate was 74% with dalbavancin vs 85% with SoC (P = .004).
Dalbavancin was more costly than SoC for the treatment of ABSSSI, with a higher 30-day readmission rate. Dalbavancin does not offer an economic or efficacy advantage.
急性细菌性皮肤和皮肤结构感染（ABSSSI）是常见的传染病，给医疗保健系统带来了巨大的经济负担。本研究旨在比较达巴万星与标准治疗（SoC）在社区医疗系统中治疗 ABSSSI 的成本效益。
这是一项回顾性研究，纳入了在 27 个月期间接受达巴万星或 SoC 治疗的 ABSSSI 成年患者。根据年龄和体重指数对患者进行匹配。主要结局为每位患者对医疗保健系统的平均净护理成本，计算方法为报销支付与为患者提供护理的总成本之间的差异。次要结局为成功治疗的比例，定义为治疗开始后 30 天内无 ABSSSI 相关再入院。
在 418 例匹配患者中，209 例接受 SoC 治疗，209 例接受达巴万星治疗。达巴万星组每位患者的平均总护理成本高于 SoC 组（$4770 比 $2709，P <.0001）。达巴万星组每位患者的平均报销额为$3084，SoC 组为$2633（P =.527）。达巴万星组的净成本（收入减去总成本）为$1685，SoC 组为$75（P =.013）。达巴万星组的整体治疗成功率为 74%，SoC 组为 85%（P =.004）。
达巴万星治疗 ABSSSI 的成本高于 SoC，30 天再入院率更高。达巴万星在经济或疗效方面没有优势。
