Impact of glycopeptide therapy after hospital discharge on inpatient costs: A comparison of teicoplanin and vancomycin

Data were collected prospectively from 59 patients receiving vancomycin and 20 patients receiving teicoplanin. The mean daily drug cost was pound 52.40 for teicoplanin and pound 31.13 for vancomycin; the 95% Confidence Intervals (CI) for the difference in mean drug costs varied between pound 14.40 and pound 28.10 in favour of vancomycin. Use of a loading dose of teicoplanin significantly increased mean daily drug costs if the duration of treatment was less than 10 days. Costs of preparation, administration and monitoring were consistently higher for vancomycin than for teicoplanin and inclusion of these costs reduced the difference in mean daily costs to pound 13.01 (95% CI pound 6.10 to pound 19.90). In Dundee 11 of 20 patients who received teicoplanin had received some of their treatment after discharge from the hospital and a survey of UK hospitals confirmed that teicoplanin treatment after discharge is being used in a wide range of conditions. The median proportion of teicoplanin treatment in Dundee given after discharge was 28.4% for each patient who received the drug: the median proportion of non-inpatient therapy was 50% per patient of those who received any teicoplanin treatment after discharge. Assuming that teicoplanin costs pound 20 per day more than vancomycin, use of teicoplanin implies an investment of pound 70.42 to gain one hospital day through earlier discharge of patients receiving teicoplanin.