Cost-effectiveness of telavancin versus vancomycin for treatment of complicated skin and skin structure infections

Pharmacotherapy. 2008 Dec;28(12):1471-82. doi: 10.1592/phco.28.12.1471.


Study objective: To determine the cost-effectiveness of telavancin versus vancomycin for the treatment of complicated skin and skin structure infections (cSSSIs).

Design: Pharmacoeconomic analysis conducted from the hospital's perspective using data from the Assessment of Telavancin in Complicated Skin and Skin Structure Infections (ATLAS) phase III clinical trial.

Setting: One hundred twenty-nine hospitals in the United States and internationally.

Patients: A total of 1044 clinically evaluable patients who were hospitalized with a cSSSI during the ATLAS trial and who received at least one dose of telavancin or vancomycin in the hospital.

Measurements and main results: Diagnosis-related group-specific hospital bed costs, antibiotic acquisition prices, and cost of vancomycin monitoring were applied to the resource utilization data collected during the ATLAS trial. Infection-related length of stay (LOS(ir)) and hospitalization costs (COST(ir)) were compared between the telavancin (514 patients) and vancomycin (530 patients) groups. Incremental cost-effectiveness ratios (ICERs) were calculated for the total population and a subset of patients infected with methicillin-resistant Staphylococcus aureus (MRSA) by using a 25,000-sample bootstrap analysis. During sensitivity analyses, the daily acquisition price for telavancin was increased from the equivalent to vancomycin ($13.44) to $50, $100, $150, or $200, and the rate of MRSA acquisition was varied between 30% and 75%. The median (interquartile range) LOS(ir) was 8 days (6-12 days) for both telavancin and vancomycin (p=0.742), and median (interquartile range) COST(ir) was $8118 ($6291-11,758) and $8185 ($6474-11,405), respectively (p=0.560). Similar findings were observed for the MRSA subset. Telavancin cost-effectiveness was greater for the MRSA population versus the total population. During bootstrap analyses of the MRSA population, the ICER for telavancin ranged from dominant (-$9560) to $27,889 as acquisition price was increased.

Conclusions: Telavancin LOS(ir) and total COST(ir) were similar to those of vancomycin for the treatment of cSSSIs. Particularly in those infected with MRSA, telavancin may be more cost-effective than vancomycin over the range of acquisition prices tested.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Aminoglycosides / chemistry
  • Aminoglycosides / economics
  • Aminoglycosides / therapeutic use*
  • Anti-Bacterial Agents / economics
  • Anti-Bacterial Agents / therapeutic use
  • Clinical Trials, Phase III as Topic
  • Cost-Benefit Analysis / methods
  • Databases, Factual / economics
  • Databases, Factual / statistics & numerical data
  • Drug Utilization Review / economics
  • Drug Utilization Review / statistics & numerical data
  • Female
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data
  • Humans
  • Lipoglycopeptides
  • Male
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Middle Aged
  • Multicenter Studies as Topic
  • Skin / drug effects*
  • Skin / microbiology
  • Skin / pathology
  • Staphylococcal Skin Infections / drug therapy*
  • Staphylococcal Skin Infections / microbiology
  • Vancomycin / economics
  • Vancomycin / therapeutic use*


  • Aminoglycosides
  • Anti-Bacterial Agents
  • Lipoglycopeptides
  • Vancomycin
  • telavancin