Late Breaking Original Research
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction: Intravenous vancomycin is frequently used to treat complicated infections caused by Gram-positive organisms. Although daptomycin can also be used to treat many of these same infections, the cost of daptomycin has historically made this agent less preferable. Recently, the cost of daptomycin has decreased, raising the question of whether using daptomycin can reduce outpatient cost expenditures for Kaiser Permanente home infusion pharmacies (HIP).
Research Question or Hypothesis: What is the cost of administering and monitoring intravenous vancomycin versus daptomycin through a HIP?
Study Design: This was a multi-center retrospective chart review.
Methods: Adults age =18 years prescribed either vancomycin or daptomycin through a HIP for =7 days between August 1 - December 27, 2022 were included. Variables extracted through manual chart review included demographic and clinical characteristics, total pharmacist monitoring time, and number of associated monitoring labs. The cost of antibiotics, associated labs, and pharmacist time spent monitoring patients were assessed to infer the total cost per day of therapy (DOT).
Results: 113 patients were included; 56 received daptomycin and 57 received vancomycin. Pharmacists spent less time monitoring patients who received daptomycin compared to vancomycin (14.5 vs. 24.9 minutes per DOT, p = 0.0051). Patients who received daptomycin had a similar drug cost per DOT compared to vancomycin patients ($36.63 vs $38.41, p = 0.5750). When the cost of drug, pharmacist time, and labs were combined, patients who received daptomycin had a significantly lower mean overall cost per DOT compared to vancomycin patients ($66.47 vs $90.41, p = 0.0450).
Conclusion: Daptomycin is less costly for a HIP to administer and monitor than vancomycin. In addition, pharmacists spend significantly less time monitoring daptomycin patients. This information can guide institution-specific practices pertaining to prescribing vancomycin or daptomycin in the outpatient setting.
Presenting Author
Katherine Yang PharmD, BCPSErie County Medical Center
Authors
Wendy Morimoto PharmD
Kaiser Permanente
Kristina Wong PharmD
Kaiser Permanente
Mehrnaz Zahiri PharmD
Kaiser Permanente
Meredith Silverman MD
Kaiser Permanente