Cost-effectiveness of linezolid versus vancomycin for hospitalized patients with complicated skin and soft-tissue infections in France

Med Mal Infect. 2009 May;39(5):330-40. doi: 10.1016/j.medmal.2009.01.005. Epub 2009 Mar 21.

Abstract

Studies have shown similar clinical cure rates and shorter length of hospitalization when using linezolid compared to vancomycin in patients with complicated skin and soft-tissue infections due to suspected or proven methicillin-resistant Staphylococcus aureus (MRSA).

Objective: This study had for aim to compare the cost-effectiveness of linezolid versus vancomycin in French healthcare settings.

Method: A decision-analytic model followed an average patient from the initiation of an empiric treatment until cure, death or second-line treatment failure. A clinical data probability was obtained from clinical trials, resource utilization data (including treatment duration and length of hospitalization) and prevalence of MRSA was obtained from a Delphi panel, and costs from published sources.

Results: First-line cure rate for linezolid-treated patients was 90.7% versus 85.5% for vancomycin; the total cure rates after two lines of treatment were 98.5% and 98.0%, respectively. The average total cost was 7,778euro for linezolid versus 8,777euro for vancomycin. The mean estimated length of hospitalization after two lines of treatment was 10.7 days for linezolid versus 13.3 days for vancomycin. The increased effectiveness and reduced cost lead to more frequent prescription. This did not change after one-way sensitivity analyses.

Conclusion: Linezolid may be considered as a cost-effective treatment for patients with complicated skin and soft-tissue infections suspected to be MRSA related in France.

MeSH terms

  • Acetamides / economics
  • Acetamides / therapeutic use*
  • Anti-Bacterial Agents / economics
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents / economics
  • Anti-Infective Agents / therapeutic use*
  • Decision Trees
  • Drug Monitoring / methods
  • Drug Monitoring / standards
  • France
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / economics
  • Humans
  • Inpatients
  • Linezolid
  • Methicillin-Resistant Staphylococcus aureus*
  • Oxazolidinones / economics
  • Oxazolidinones / therapeutic use*
  • Skin Diseases, Infectious / drug therapy*
  • Soft Tissue Infections / drug therapy*
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / economics
  • Staphylococcal Skin Infections / drug therapy*
  • Staphylococcal Skin Infections / economics

Substances

  • Acetamides
  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Oxazolidinones
  • Linezolid