Cost Analysis of Vancomycin versus Daptomycin for Methicillin-Resistant Staphylococcus aureus Bacteremia: A Method of Unburdening the Vancomycin Consult Service
by Travis Witt, PharmD, Philip Whitfield, PharmD, BCIDP
Abstract:
Objectives:
The objective of this study was to examine the cost difference between vancomycin and daptomycin using a novel “what if” analysis in a real population of patients with MRSA bacteremia.
Methods:
This was a descriptive analysis of patients with MRSA bacteremia, admitted to a rural Wisconsin hospital from June 1, 2021, through May 31, 2023. For each included patient, the electronic health record was reviewed for drug, dose, and duration of antimicrobial therapy. Patients were excluded from the analysis if bacteremia was secondary to pneumonia or if there was inadequate source control. The total defined daily doses of anti-MRSA agents were calculated and then attributed to two “what-if” scenarios: one scenario if vancomycin were administered for the entire treatment duration, and the second if daptomycin. A total treatment cost, including direct and indirect costs, was then attributed to each scenario per patient. Median treatment costs were then compared across the vancomycin and daptomycin scenarios.
Results:
A total of 18 cases of MRSA bacteremia were reviewed. Vancomycin was universally the initial antibiotic administered. The median total cost of antimicrobial treatment was $440.50 for vancomycin and $351.50 for daptomycin. Direct costs of vancomycin were lower than daptomycin ($273.20 versus $344.50); however, the indirect costs of vancomycin were higher than daptomycin ($167.30 versus $7.00).
Conclusion:
Daptomycin may be lower in cost than vancomycin when treating for MRSA bacteremia due to large differences in indirect costs such as drug level monitoring.
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2025 July/August Table of Contents
Abstract:
Objectives:
The objective of this study was to examine the cost difference between vancomycin and daptomycin using a novel “what if” analysis in a real population of patients with MRSA bacteremia.
Methods:
This was a descriptive analysis of patients with MRSA bacteremia, admitted to a rural Wisconsin hospital from June 1, 2021, through May 31, 2023. For each included patient, the electronic health record was reviewed for drug, dose, and duration of antimicrobial therapy. Patients were excluded from the analysis if bacteremia was secondary to pneumonia or if there was inadequate source control. The total defined daily doses of anti-MRSA agents were calculated and then attributed to two “what-if” scenarios: one scenario if vancomycin were administered for the entire treatment duration, and the second if daptomycin. A total treatment cost, including direct and indirect costs, was then attributed to each scenario per patient. Median treatment costs were then compared across the vancomycin and daptomycin scenarios.
Results:
A total of 18 cases of MRSA bacteremia were reviewed. Vancomycin was universally the initial antibiotic administered. The median total cost of antimicrobial treatment was $440.50 for vancomycin and $351.50 for daptomycin. Direct costs of vancomycin were lower than daptomycin ($273.20 versus $344.50); however, the indirect costs of vancomycin were higher than daptomycin ($167.30 versus $7.00).
Conclusion:
Daptomycin may be lower in cost than vancomycin when treating for MRSA bacteremia due to large differences in indirect costs such as drug level monitoring.
Download PDF
2025 July/August Table of Contents