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Journal of Antimicrobial Chemotherapy (1996) 37, 623-633
© 1996 The British Society for Antimicrobial Chemotherapy

research-article

Impact of glycopeptide therapy after hospital discharge on inpatient costs: a comparison of teicoplanin and vancomycin

Peter G. Daveya, Richard Southb and Mo Malekc

aPharmacoeconomics Research Centre, Ninewells Hospital and Medical School Dundee DDl 9SY, UK bMarion Merrell Dow Ltd, Lakeside House Stockley Park, Uxbridge UB11 1BE, UK cPharmacoeconomics Research Centre, Department of Economics, University of St Andrews St Andrews, UK

Received 17 February 1995; returned 11 July 1995; accepted 18 September 1995

Data were collected prospectively from 59 patients receiving vancomycin and 20 patients receiving teicoplanin. The mean daily drug cost was £52.40 for teicoplanin and £31.13 for vancomycin; the 95% Confidence Intervals (CI) for the difference in mean drug costs varied between £14.40 and £28.10 in favour of vancomycin. Use of a loading dose of teicoplanin significantly increased mean daily drug costs if the duration of treatment was less than 10 days. Costs of preparation, administration and monitoring were consistently higher for vancomycin than for teicoplanin and inclusion of these costs reduced the difference in mean daily costs to £13.01 (95% CI £6.10 to £19.90). In Dundee 11 of 20 patients who received teicoplanin had received some of their treatment after discharge from the hospital and a survey of UK hospitals confirmed that teicoplanin treatment after discharge is being used in a wide range of conditions. The median proportion of teicoplanin treatment in Dundee given after discharge was 28.4% for each patient who received the drug: the median proportion of non-inpatient therapy was 50% per patient of those who received any teicoplanin treatment after discharge. Assuming that teicoplanin costs £20 per day more than vancomycin, use of teicoplanin implies an investment of £70.42 to gain one hospital day through earlier discharge of patients receiving teicoplanin.


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