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Current MRSA Antibiotics to Face Competition From Two Newer Drugs

Dalbavancin and oritavancin may be more convenient in the outpatient setting (November 19)

Decision Resources, a research and advisory firm located in Burlington, Massachusetts, finds that more than 75% of surveyed physicians anticipate that they will be prescribing Durata’s dalbavancin and The Medicine Company’s oritavancin as parenteral antimicrobial therapy (OPAT) for nonhospitalized patients with complicated skin and skin-structure infections (cSSSIs) and osteomyelitis.

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 (daptomycin) in the cSSSI/osteomyelitis OPAT market.

In the U.S, OPAT has become a widespread treatment practice as a result of its potential to reduce health care 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 intravenous (IV) vancomycin and daptomycin, have been successful in the cSSSI/osteomyelitis OPAT markets, as MRSA is a common cause of these infections in the U.S. Both agents were prescribed by at least 75% of surveyed physicians for these conditions in the previous 12 months.

Despite the lower cost and long clinical history of IV vancomycin, daptomycin appears to be the drug most likely to grow in the cSSSI/osteomyelitis segment of the OPAT market. Nearly two-thirds of surveyed physicians anticipate increasing their prescribing of this agent as OPAT in the next 12 months.

Analyst Hannah Cummings, PhD, from Decision Resources, said, “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. 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 tedizolid (Cubist/Bayer Healthcare), as well as that of lower-cost, generic linezolid (Zyvox/Zyvoxid, Pfizer), which will also be vying for use in the outpatient MRSA market. Although prolonged treatment with linezolid is typically precluded because of myelosuppression, tedizolid’s safety profile may allow longer-term usage, which could also promote the adoption of the IV formulation of this agent.

[Source: Decision Resources; November 19, 2013.]

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