Table 2.
Vancomycin and Daptomycin Cost Comparison for a 75-kg Adult With Methicillin-Resistant Staphylococcus aureus Bacteremia
| Drug/Intervention | Item Cost | Item Frequency | Duration of Therapy | ||
|---|---|---|---|---|---|
| 14 Days | 28 Days | 42 Days | |||
| VAN 1 g | $1.94a | 2 g load, then 1 g twice daily | $56.26 | $110.58 | $164.90 |
| VAN serum level monitoring, trough only [43] |
$141b | Three times every 2 wk (conservative) | $423 | $846 | $1692 |
| VAN serum level monitoring, 2-level AUC [43] |
$141b | Three times every 2 wk (conservative) | $846 | $1692 | $3384 |
| Pharmacist coordinating, interpreting, and documenting TDM, trough only | $60/h | 15 min, $15 × 3 | $45 | $90 | $135 |
| Pharmacist coordinating, interpreting, and documenting TDM, 2-level AUCc |
$60/h | 20 mind, $20 × 3 | $60 | $120 | $180 |
| Total coste of vancomycin (range based on PK monitoring strategy) | $524–$962 | $1045–$1923 | $1992–$3729 | ||
| Daptomycin 500 mg | $25.31a | 600 mg (~8 mg/kg) once dailyf | $425.20 | $850.42 | $1275.62 |
| Total coste of daptomycin | $425 | $850 | $1276 | ||
Estimates for drug costs are based on actual wholesale price due to variability in patient/third-party payer costs.
Abbreviations: AUC, area under the curve; PK, pharmacokinetic; TDM, therapeutic drug monitoring; VAN, vancomycin.
Average average wholesale price from 2 institutions.
Average laboratory cost from 2 institutions.
AUC can be estimated using a single level with Bayesian software. The cost of purchasing and deploying such software is variable and beyond the scope of this cost analysis.
Twenty minutes instead of 15 minutes used because of time needed to coordinate the second level.
Rounded to the nearest dollar.
Based on 75 kg patient weight.