A cost minimisation analysis comparing oral linezolid and intravenous daptomycin administered via an outpatient parenteral antibiotic therapy programme in patients requiring prolonged antibiotic courses

Abstract

This study is an economic analysis seeking to examine cost savings that may be accrued from usage of oral linezolid in place of OPAT IV daptomycin in patients requiring prolonged courses of IV or highly bioavailable oral antibiotic therapy. In order to do so we conducted a literature review to establish the scenarios in which the agents could be considered equivalent. We then, using a decision-tree model, conducted a cost analysis to establish differences in cost between the approaches. Under the model base-case, the total cost of treatment with OPAT daptomycin was €3,496.84 and the total cost of treatment with oral linezolid was €772.01. Therefore the oral linezolid strategy would be projected to save the Irish health service €2,724.83 per patient. These results were robust to one-way deterministic sensitivity analyses and probabilistic sensitivity analysis. Our study suggests that significant savings could be safely accrued in the management of these patients.

Highlights

• Oral linezolid is as effective as IV (intravenous) daptomycin in appropriate treatment scenarios

• Cost minimisation analysis deems oral linezolid substantially cheaper than IV daptomycin

• In the base case, treatment with oral linezolid would save €2,724.83 per patient treated

• Findings were robust to one-way and probabilistic sensitivity analyses

Keywords:

• Outpatient parenteral antibiotic therapy (OPAT)
• oral antibiotic therapy
• economic analysis
• cost minimisation analysis
• linezolid
• daptomycin

Disclosure statement

The authors have no conflicts of interest to declare.

Ethics approval

Ethics approval for this research was granted by the University College Cork Clinical Research Ethics Committee. Reference number: ECM 4 (g) 6/7/2021.

Authors’ contributions

Dr EF: Designed study, collected data, designed model, statistical analysis, drafted paper. Dr AJ: Advised regarding study design and clinical aspects, edited paper.

Additional information

Funding

This research received no funding or grant from any funding agency in the commercial, public or not-for-profit sectors.