Growing Concern over the Efficacy of Vancomycin is Prompting Greater Use of Branded Therapies for the Treatment of MRSA Infections
To Effectively Compete with Current Anti-MRSA Therapies, Emerging Agents Will Need to be Amenable to Outpatient Use, According to Findings from Decision Resources Group
BURLINGTON, Mass., July 7, 2014 /PRNewswire/ — Decision Resources Group finds that, although vancomycin continues to be the standard-of-care for infections caused by methicillin-resistant Staphylococcus aureus (MRSA), there is growing concern among infectious disease (ID) specialists over rising vancomycin minimum inhibitory concentrations (MICs) among hospital MRSA isolates. Nearly two-thirds of ID specialists who have made changes to their prescribing practices over the past two years indicated using higher dosages of vancomycin, or “push the dose”, in order to increase trough levels of the drug. At the same time, among physicians who indicated increasing usage of Cubist’s Cubicin, Pfizer’s Zyvox, or Forest’s Teflaro in the last 12 months, elevated vancomycin MICs were cited as one of the most common reasons for greater prescribing of these brands.
Other key findings from the TreatmentTrends report entitled Methicillin-Resistant Staphylococcus Aureus 2014 (US):
-- Hospital-acquired (HA) MRSA and community-acquired (CA) MRSA: HA-MRSA and CA-MRSA remain the two most concerning Gram-positive pathogens among surveyed ID specialists. In general, MRSA patients incur greater costs per day and longer hospital stays compared to patients with infections due to other Gram-positive pathogens. In addition, MRSA infections are more likely to require later lines of therapy and/or use of combination therapy. -- Outpatient parenteral antibiotic therapy (OPAT): More than half of surveyed physicians indicated that over the past two years they have increased the number of MRSA patients discharged on OPAT. As this trend continues, new parenteral agents with convenient dosing schemes such as Dalvance's (Durata) two dose regimen administered weekly and Orbactiv's (The Medicines Company) single dose regimen will be well-positioned to compete in this highly competitive market. Dalvance is expected to be the first to launch, having received FDA approval for treatment of cSSSIs/ABSSSIs in May 2014. Orbactiv's NDA is currently under FDA review with a PDUFA date scheduled for August 6, 2014.
Comments from Decision Resources Group Analyst Maria Ascano, Ph.D.:
-- "As hospitals aim to reduce healthcare costs by minimizing hospital admissions or the length of hospital stays, agents amenable to outpatient use, such as having convenient dosing for OPAT or availability in bioequivalent oral formulations, will allow physicians to discharge MRSA patients earlier. However, as pressure mounts for hospitals to reduce readmissions rates, it will be critical for these outpatient therapies to demonstrate high clinical cure rates." -- "Three-quarters of surveyed ID specialists indicated they would prescribe Cubist's second-generation oxazolidinone, Sivextro, over Pfizer's Zyvox for the treatment of skin infections due to MRSA. These results highlight high physician awareness of Sivextro's key improvements over Zyvox, including less-frequent dosing, similar efficacy in a shorter course of therapy, and potential for fewer adverse events--particularly those associated with prolonged use."
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