MRSA Infections ( How Will U.S. Physician and Payer Receptivity to Novel Therapies Influence the Hospital-Treated Infections Market?) | Physician & Payer Forum | US | 2014

The hospital-treated methicillin-resistant Staphylococcus aureus (MRSA) infection market is dominated by generic vancomycin because of its low cost, physician familiarity and relatively high clinical efficacy. Meanwhile, a number of premium-priced, branded agents (e.g., linezolid [Pfizer’s Zyvox/Zyvoxid] and daptomycin [Cubist/Novartis/Merck’s Cubicin]) compete for limited patient populations requiring later lines of therapy and/or suffering from difficult to treat MRSA infections (e.g., nosocomial pneumonia, bloodstream infections, and osteomyelitis). Therefore, emerging anti-MRSA agents will need to demonstrate improvements across multiple drug attributes including safety, tolerability, efficacy, and delivery in order to gain patient share in this increasingly crowded market landscape. Nevertheless, the MRSA pipeline offers a number of promising emerging therapies that can address areas of unmet need. Cubist’s second-generation oxazolidinone tedizolid (Sivextro) offers a range of improvements over linezolid, including shorter length of therapy, lower drug dosage, once-daily dosing, and the potential for a safer and more tolerable drug profile. In addition, two emerging lipoglycopeptides dalbavancin (Durata’s Dalvance) and oritavancin have the potential to transform the standard-of-care for MRSA infections through once-weekly (dalbavancin), or single-dose (oritavancin) regimens. Infrequent dosing not only provides greater convenience to patients, but can also help facilitate outpatient parenteral antibiotic therapy (OPAT), which in turn can help reduce the overall length and cost of hospitalization.

This report surveys physicians and hospital pharmacy directors (PDs) regarding current practices for hospital-based treatment of bacterial infections due to MRSA. Analysis will be derived from a survey of 140 hospital-based physicians (70 infections disease specialists (ID) and 70 non-ID physicians and 30 hospital PDs. Physician surveys will assess current prescribing practices for marketed anti-MRSA antibiotics, how those practices are evolving due to shifting epidemiology and/or hospital policies, areas of unmet need and expected uptake of emerging anti-MRSA therapies. The survey of hospital-based PDs will provide insight into factors influencing formulary inclusions/positioning for both current and emerging antibiotics. Key anti-MRSA agents to be surveyed include the following current therapies: vancomycin (generics), linezolid, daptomycin, ceftaroline (Forest’s Teflaro/AstraZeneca’s Zinforo/Dainippon Sumitomo), and telavancin (Theravance/Clinigen’s Vibativ). In addition, these surveys will assess physician and payer interest in three emerging MRSA therapies in late-stage clinical development: tedizolid, dalbavancin, and oritavancin.