Outpatient parenteral antimicrobial therapy (OPAT) allows patients with clinically stable infections (e.g., skin and soft tissue infections, bone and joint infections, osteomyelitis, intra-abdominal infections, urinary tract infections) requiring intravenous (IV) antibiotics to be treated outside the hospital. OPAT has become a widespread practice in the United States due to its potential to reduce healthcare costs, improve convenience, and decrease the risk of complications. Given the push for cost containment and development of efficacious IV antimicrobial agents that offer advantages in safety, tolerability, and/or delivery, commercial opportunities in the OPAT market exist for novel branded agents. However, emerging therapies must compete against, and demonstrate significant benefits over, entrenched generic products in a highly cost-sensitive healthcare climate.
The U.S. Physician & Payer Forum report entitled Outpatient Parenteral Antimicrobial Therapy: What Opportunities and Barriers Will Shape the OPAT Market Access Landscape in the United States? examines the prescribing and reimbursement environment for current and emerging IV antibiotics for use as OPAT among surveyed infectious disease (ID) specialists and surveyed managed care organization (MCO) pharmacy directors and medical directors. This report explores stakeholder perspectives that affect prescribing and reimbursement of key branded antibiotics for OPAT-suitable infections due to Gram-negative pathogens (GNPs) and methicillin-resistant Staphylococcus aureus (MRSA), and dynamics that will promote or restrict market access and uptake of emerging therapies to treat these infections. The report examines the range of IV antibiotics used to treat infections due to GNPs or MRSA in the outpatient setting; however, the report has a particular focus on the market access dynamics for Merck’s Invanz (ertapenem), Merck’s Cubicin (daptomycin), Allergan’s Dalvance (dalbavancin), and The Medicines Company’s Orbactiv (oritavancin). The report evaluates current prescribing patterns, the fit of emerging therapies in the outpatient treatment paradigm, formulary status of current and emerging therapies, and areas of unmet need.