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Durata Therapeutics (NASDAQ:DRTX) today announced cost-analysis data from a study investigating outpatient-based therapy for acute bacterial skin and soft tissue infections (abSSTI, a term synonymous with the more commonly used acute bacterial skin and skin structure infections, or ABSSSI). The data, presented at the 52
nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), showed the potential to reduce direct medical costs nearly in half compared to inpatient treatment of ABSSSI.
“Our research team observed that caring for ABSSSI patients in outpatient settings rather than in the hospital may present an opportunity to reduce resource use and treatment costs up to 44 percent. PICC (peripherally inserted central catheter) lines also represent a substantial economic burden accounting for 28 to 43 percent of outpatient costs,” said Alexandra Khachatryan, MPH, outcomes research manager, Pharmerit North America LLC, and the lead author of the abstract presented at the 2012 ICAAC meeting.
According to Russ Petrak, M.D., an infectious disease specialist for the past 25 years, “Many ABSSSI patients can be treated in outpatient settings. There’s no need for them to be in the hospital, but today that remains the dominant modality. Newer treatment regimens that have the ability to reduce inpatient stay and remove the burden of PICC lines may help alleviate the economic burden of ABSSSI.”
Abstract Presented at ICAAC 2012Costs of Outpatient Parenteral Antibiotic Therapy (OPAT) for the Management of Gram+ Acute Bacterial Skin and Soft Tissue Infections (abSSTIs) (Khachatryan, et al). Session Number: 020, Presentation Number: K-239Background: Extended inpatient care and/or OPAT to deliver intravenous antibiotics are often required in the treatment of Gram+ abSSTIs. Economic drivers of OPAT provided either in the patient’s home, physician office, or infusion center have not been well described in the literature. This analysis estimated, from a US payer perspective, costs of treating Gram+ abSSTIs with inpatient care followed by OPAT.
Methods: A decision tree model was used to estimate direct non-drug medical cost of treating Gram+ abSSTIs. Published trials provided efficacy and adverse event (AE) inputs. Inpatient length of stay (LOS), office visits, OPAT visits/equipment, and AEs were mapped in detail from the literature and standard reimbursement sources. In the base case analysis, equal efficacy among treatments was assumed while varying inpatient LOS and OPAT days. Results were generated for 3-, 5-, and 7-day inpatient scenarios followed by OPAT to achieve a total length of treatment of 14 days. Ranges for OPAT costs reflected once or twice daily infusions. All costs were adjusted to U.S. dollars
Results: Total non-drug medical cost of treatment for abSSTI ranged from $8,790- $15,968. Inpatient medical costs included hospital cost per day ($1853) and cost of AEs ($343). Outpatient medical management with OPAT included either the daily home care ($194) or infusion center fee ($154), insertion of PICC line with fluoroscopy ($786), PICC complications ($188), labs ($102), and physician office visit for evaluation of abSSTI ($222). Inpatient vs outpatient cost breakdown by LOS was: 3 days inpatient ($5,902) / 11 days OPAT ($2,888-$3,429); 5 days inpatient ($9,608) / 9 days OPAT ($2,580-$3,042); 7 days inpatient ($13,314) / 7 days OPAT ($2,273-$2,654).
Conclusions: Shifting treatment of abSSTI from inpatient to OPAT settings may result in direct medical cost savings up to 44%. Typical OPAT scenarios represent roughly a third of the total medical cost of treatment. Within OPAT, PICC line costs/complications account for 28-43% of the OPAT burden. The future economic benefit of new therapies for abSSTI may be driven in part by the ability to reduce inpatient LOS and OPAT costs.
“This work suggests that treating the appropriate ABSSSI patient in an outpatient setting may help reduce overall treatment costs,” said Durata Therapeutics Chief Executive Officer Paul R. Edick. “We believe an ABSSSI therapy dosed once weekly and proven to be safe and effective may help facilitate the move to the outpatient setting.”