Based on the 105 hospitals in this study, Teflaro has a 50 percent chance of being added to a hospital’s formulary following P&T committee review, while Dificid has a slightly higher chance of earning formulary inclusion.
November 14, 2011—Exton, Penn.—Arlington Medical Resources (AMR) finds that in addition to managing the hospital’s anti-infective formulary, hospital pharmacy and therapeutics (P&T) committees most frequently cite management of issues related to antibiotic resistance, drug cost/cost effectiveness, and appropriate antibiotic selection/use. One mechanism hospitals are using to manage antibiotic use is antimicrobial stewardship programs; nearly three-quarters of hospitals in this study have an established, formal antimicrobial stewardship program.
P&T committees report ongoing efforts to minimize the number of therapeutically equivalent products on formulary. Data from this study show that although ertapenem (Merck’s Invanz), meropenem (AstraZeneca’s Merrem, generics), and imipenem-cilastatin (Merck’s Primaxin) have near equal high rates of hospital formulary inclusion and formulary uptake of doripenem (J&J’s Doribax) has rapidly climbed over the last five years, the perceived therapeutic equivalence of carbapenems is leading P&T committees to limit the number of carbapenems on formulary. The generic availability of meropenem has clearly put this drug among the preferred on-formulary carbapenems. Similarly, as P&T committees try to reduce the number of therapeutically-equivalent antifungals on formulary, they tend to have one echinocandin (i.e., Merck’s Cancidas [caspofungin], Astellas’s Mycamine/Funguard [micafungin], or Pfizer’s Eraxis [anidulafungin]) on formulary and a preference for one newer azole (i.e., Pfizer’s Vfend [voriconazole] or Merck’s Noxafil [posaconazole]).
“Minimizing the number of on-formulary drugs for serious gram-positive infections is less of an issue for Zyvox and Cubicin, which have extremely high rates of formulary inclusion across hospitals of various sizes. However, we find that the practice of limiting the number therapeutically equivalent drugs on formulary is a clear barrier for formulary uptake of Vibativ,” said AMR’s Vice President of Research Danielle L. Drayton, Ph.D. “Once added to formulary, Vibativ as well as Zyvox and Cubicin tend to be restricted not only by requisite ID specialist approval, but also restricted for use in specific patient populations such as those with confirmed MRSA infection or vancomycin failure.”
This study also finds that pharmacoeconomic analyses and specific drug-related cost assessments are regularly used as part of the anti-infectives formulary decision-making process. Indeed, cost is cited as a key consideration in the ongoing formulary decisions for ceftaroline (Forest/AstraZeneca’s Teflaro), fidaxomicin (Optimer/Cubist’s Dificid), and future assessments of Astellas/Basilea’s emerging azole isavuconazole.
About Hospital Formulary Insights: Anti-Infectives
Hospital Formulary Insights: Anti-Infectives is a new syndicated report series from AMR that provides an in-depth view of the hospital formulary decision-making process for antibiotics and antifungal therapies in the United States. Through primary market research with hospital pharmacy directors and infectious disease specialists that sit on their hospital's P&T committee, we are able to understand the influence of cost factors, clinical factors, and product attributes on anti-infective formulary decisions. In addition,
Hospital Formulary Insights: Anti-Infectives provides information on the stocking, formulary status, and restriction status of key antibiotic and antifungal brands and why drugs are or are not included on hospital formularies. This study also contains historical formulary data from AMR’s proprietary hospital formulary database regarding the formulary uptake of antibiotic and antifungal brands over the last 10 years.
AMR will be conducting a webinar following the release of this study on Thursday, November 17th at 10am EST entitled,
Hospital Formulary Insights for Anti-Infectives: Assessing Formulary Decision-Making and Formulary Uptake of Key Brands in the United States. This webinar is available only to purchasers of this study. Please
contact us to learn how you can purchase this study, attend the webinar, and have full access to the authors of this study.
About Arlington Medical Resources, LLC
AMR (
www.AMR-data.com) serves the market intelligence needs of the pharmaceutical and diagnostic imaging industries. Research includes clinical inpatient databases that directly link anti-infective drug with indication/procedure, formulary and stocking status tracking studies, drug purchasing audits and diagnostic imaging procedure volume/contrast media usage audits. AMR is a Decision Resources Group company.
About Decision Resources Group
Decision Resources Group is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Please visit Decision Resources Group at
www.DecisionResourcesGroup.com.
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