Outpatient Parenteral Antimicrobial Therapy (OPAT) in Patients with Limited Insurance Coverage: Cost Impact of Early Discharge with Long-Acting Dalbavancin

Document Type

Abstract

Publication Date

3-6-2026

Abstract

Purpose: Uninsured and underinsured patients face barriers to Outpatient Parenteral Antimicrobial Therapy (OPAT). As a result, these patients often require extended hospital stays for intravenous (IV) antibiotics. Dalbavancin, a long-acting lipoglycopeptide, allows for multiple weeks of treatment of gram-positive infections with one to two doses and may be available through patient assistance programs. This study evaluated patients who were discharged after receiving dalbavancin through these programs. The objective was to assess cost savings by comparing hospital length of stay with dalbavancin administration compared to length of stay had standard IV antibiotics been used. Methods: Patients to be evaluated were those who were uninsured or underinsured and received a dose of inpatient dalbavancin obtained through a patient assistance program. Eligible patients included adults who were treated with dalbavancin for a gram-positive infection, starting in May 2023 to October 2025. Additionally, patients fitting inclusion criteria for the study who received dalbavancin therapy during the data-collection period will be included in the results. De-identified data in this retrospective evaluation were collected from the electronic medical record and included patient demographics, infection type, relevant microbiological results, admission date, discharge date, inpatient antimicrobial therapies, timing of dalbavancin administration, and planned duration of total antibiotic therapy. This analysis compared the actual length of hospital stay prior to dalbavancin administration with the projected inpatient duration had the patient received a full course of standard intravenous antibiotics. Estimates for prolonged hospitalization were derived from documented treatment plans and standard antimicrobial practice guidelines. Associated hospital costs were calculated using institutional cost-per-day estimations as well as drug costs for antibiotics used during the projected inpatient stay. The cost of dalbavancin acquisition was determined by the patient assistance programs. Data were evaluated to quantify the cost impact of dalbavancin compared to standard inpatient antibiotics. Study investigators evaluated the cost impact and assessed potential implications for expanding treatment access among patients with limited insurance coverage.

Publication Title

American Journal of Health-System Pharmacy

Volume

83

Issue

Supplement 2

First Page

S1208

Last Page

S1208

Comments

Advancing Science, Pharmcy Practice, and Health Outcomes Midyear Clinical Meeting, ASHP 2025 held December 7-10, 2025 in Las Vegas, NV.

Link to Full Text

Open Access

Share

COinS