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Previous authors8 have used more in-depth financial models, taking into account the cost of intravenous lines, lab
tests and drug monitoring, and cost of treating adverse reactions. The in-depth analysis also differentiated inpatient and
outpatient costs, considering costs across observation,
admission, and discharge of the patient. As a future direction
to our study, a more robust financial analysis would solidify
the benefits of oritavancin as a cost-sparing option to our
institution.
The length of stay used in this analysis was initially based
on the average length of stay for treatment of cellulitis, 14
days, cited in the Infectious Disease Society of America
Guidelines on Skin and Soft Tissue Infections.2 However, a
14-day average length of stay for cellulitis, while endorsed
by the IDSA SSTI guidelines, may overestimate the true
number of days required to treat ABSSTI patients at our hospital and other institutions. A recent study looking at trends
and economic impact of ABSSTIs in the United States found
that the mean hospital length of stay was between 5.4 and 5.0
days for adult inpatients with a primary diagnosis of
ABSSTIs.6 The institution-specific average length of stay
(6.62 days) used in this analysis may therefore provide a
more accurate figure to the national average than the figure
cited in the IDSA guidelines.
One limitation to this study was the use of a national
average for hospitalization cost-per-day instead of an
institution-specific cost. The cost of hospitalization is
multifactorial and would have been prohibitively complex
to calculate for the purposes of this study; the cost of other
medications, lab tests, and medication administration
costs (including intravenous lines) would need to be taken
into account, in addition to the cost of a hospital room and
other factors. Similarly, the AWP cost of drug used in this
analysis does not take into account reimbursement through
the manufacturer's patient assistance program, nor any
group purchasing organization (GPO) or 340B discounts,
and may not represent true acquisition cost for our
institution.
As a future direction to this study, a more robust financial
impact analysis could be performed which would take into
account the number of days a patient had been admitted
before receiving oritavancin. The number of days a patient
had been admitted would be subtracted from the average
number of days for ABSSTI hospitalization, to provide a
more accurate representation of how many days of hospitalization were saved for each patient using oritavancin therapy.
A more robust financial analysis would also include the cost
of ED visit for patients with complaints related to the disease
state for which oritavancin was prescribed, as well as any
potential costs (eg, additional antibiotic therapies prescribed)
associated with these ED visits.

Hospital Pharmacy 53(4)

Conclusion
The results of our study showed that the majority of oritavancin use within a community hospital was appropriate
according to indication, and was most commonly ordered by
infectious disease physicians. If used appropriately as an outpatient alternative for the treatment of ABSSTIs, oritavancin
could save our institution over $650,000 annually by preventing hospital admissions. While the current financial
analysis may lack certain institution-specific figures, oritavancin is still expected to have potential for significant financial benefit to our hospital.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.

Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.

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http://www.orbactiv.com/pdfs/orbactiv-prescribing-information.pdf http://www.orbactiv.com/pdfs/orbactiv-prescribing-information.pdf

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