PSHP 2026 Residency Conference

Purpose: Uninsured patients face long hospital stays for IV antibiotics. This study evaluated cost savings and length of stay for patients discharged after receiving dalbavancin via patient assistance programs compared to standard IV antibiotics.


Methods: The patient population included those who received a dose of inpatient dalbavancin from a patient assistance program for treatment of a gram-positive infection. De-identified data in this retrospective evaluation were collected from the electronic medical record and included demographics, microbiological results, admission/discharge dates, and inpatient antibiotic therapies. The analysis compared actual length of hospital stay prior to dalbavancin administration with projected inpatient duration with a full course of standard IV antibiotics. Estimates for prolonged inpatient stay were derived from treatment plans and antimicrobial practice guidelines. Hospital costs were calculated with cost-per-day estimations and drug costs for inpatient antibiotics. Investigators evaluated cost impact of dalbavancin compared to standard antibiotics and assessed potential implications for expanding access to patients with limited insurance coverage.


Results: Twelve patients were included in the study population. Actual length of hospital stay prior to dalbavancin was compared to the projected inpatient duration had the patient received a full course of standard antibiotics. Length of stay (LOS) cost was determined using an approximation of $800 per day. The early discharges saved a cumulative 355 inpatient days, with cost savings of $284,000.00. The cost of inpatient antibiotic therapy was estimated using hospital acquisition costs. Dalbavancin was acquired at no cost through the patient assistance program. Total projected cost of standard therapy was $5,229.00, compared to actual cost of $3,665.00 with early discharge. The total cost savings afforded to the hospital amounted to $349,877.46.


Conclusion: Compared to standard inpatient IV antibiotics, early discharge with dalbavancin resulted in reduced costs and shortened length of stay. Through patient assistance programs, access to outpatient IV antibiotics can be expanded to include patients without insurance coverage or with high out-of-pocket costs. The significant cost savings and benefits of early discharge support the value of incorporating dalbavancin into clinical practice.


IRB Approval: The IRB reviewed your project and determined that it is not human subjects research per the federal 
regulations found at 45 CFR 46.102(l).