Current MRSA Antibiotics Will Face Competition from Durata's Dalbavancin and The Medicines Company's Oritavancin for Use in the Outpatient Setting

New Long-Acting Agents Are Poised to Challenge the Position of IV Vancomycin and Cubist's Cubicin in the OPAT Market, According to a New Report from Decision Resources Group

Nov 19, 2013, 09:00 ET from Decision Resources

BURLINGTON, Mass., Nov. 19, 2013 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that more than three-quarters of surveyed physicians anticipate prescribing Durata's dalbavancin and The Medicines Company's oritavancin as outpatient parenteral antimicrobial therapy (OPAT) for patients with complicated skin and skin structure infections (cSSSIs) and osteomyelitis (OM). These long-acting agents, whose extended half-lives allow for the convenience of once-weekly dosing, will most likely compete with vancomycin IV (Baxter/Eli Lilly; generics) and Cubist's Cubicin in the cSSSI/OM OPAT market.

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In the United States, OPAT has become a widespread treatment practice due to its potential to reduce healthcare costs, improve convenience and patient satisfaction and decrease the risk of hospital-acquired infections. Currently available antibiotics with activity against methicillin-resistant Staphylococcus aureus (MRSA), such as vancomycin IV and Cubicin, have experienced success in the cSSSI and OM OPAT markets, as MRSA is a common cause of these infections in the United States. Both agents were prescribed by at least three-quarters of surveyed physicians as OPAT for cSSSIs and OM in the past 12 months.

The U.S. Physician and Payer Forum report entitled How Will the Anticipated Availability of Once-Weekly Antibiotics Affect Current Practices in the Outpatient Treatment of Skin Infections and Osteomyelitis? finds that, despite vancomycin IV's lower cost and long clinical history, Cubicin stands as the drug most likely to experience near-term growth in the cSSSI and OM segment of the OPAT market, with nearly two-thirds of surveyed physicians anticipating increasing their prescribing of this agent as OPAT in the next 12 months.

"Cubicin's once-daily dosing, its activity against MRSA, and its favorable safety and tolerability profile make this agent an attractive option for use as OPAT," said Decision Resources Analyst Hannah Cummings, Ph.D. "Although Cubicin's once-daily dosing has tremendously improved the convenience of administration, which is a key consideration for OPAT, a further improvement on this attribute allowing for once-weekly dosing of long-acting dalbavancin and oritavancin could be an important differentiator and driver of uptake in the OPAT segment."

Both dalbavancin and oritavancin will also have to contend with the future availability of oral formulations of Cubist/Bayer Healthcare's tedizolid, as well as that of lower-cost, generic linezolid (Pfizer's Zyvox/Zyvoxid), which will also be vying for use in the outpatient MRSA market. While prolonged treatment with linezolid is typically precluded due to myelosuppression, tedizolid's safety profile may allow longer-term usage, which could also drive OPAT uptake of the IV formulation of this agent.

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