Methicillin-resistant Staphylococcus aureus (MRSA) is a clinically important Gram-positive pathogen in both the hospital and outpatient settings. The recent FDA approvals of oritavancin (The Medicine’s Company’s Orbactiv), dalbavancin (Allergan’s Dalvance), and tedizolid (Merck’s Sivextro) highlight the increasing availability of treatment options for MRSA infections, making this hospital market segment highly competitive. It will therefore be critically important for manufacturers to position their products based on differentiating attributes in order to maximize uptake in the high-value hospital market segment.

This report focuses on the treatment of inpatients with MRSA infections and analyzes the hospital prescribing practices for infections due to MRSA and other clinically important Gram-positive (GP) pathogens. The report additionally explores physician prescribing behavior and preferences in the outpatient parenteral antibiotic therapy (OPAT) setting—a key segment of the MRSA infections market. Finally, this study evaluates the advantages and disadvantages of currently available and emerging therapies to identify areas for product positioning and differentiation.

Questions Answered in This Report:

  • The inclusion of a drug on hospital treatment guidelines may greatly influence uptake and/or usage. Which MRSA infections are most likely to have established treatment guidelines, and which products are included if such guidelines exist?

  • The majority of MRSA patients are initially treated empirically until the suspected etiological agent(s) is confirmed, or ruled out. What are the shares of patients across infection types that surveyed physicians estimate are treated for suspected MRSA? What are the preference shares of MRSA agents across indications, including complicated skin and skin structure infections (cSSSI/ABSSSI), nosocomial pneumonia (NP), and osteomyelitis/joint infections?

  • OPAT represents an important segment of the MRSA market, allowing for outpatient treatment of patients requiring systemic antibiotics. What share of inpatients treated for key infections due to MRSA are discharged on OPAT? What are the preferred OPAT agents by indication, and what are the drivers and constraints in OPAT prescribing?

  • Inclusion of an agent on hospital formulary is critical for its uptake in the inpatient setting. What is the current formulary inclusion status of MRSA agents, including that of the recently launched Sivextro, Dalvance, and Orbactiv? What is the extent of physician familiarity with, and perception of, currently available therapies? How do physicians anticipate their prescribing to change over the next year?

  • Product usage, including prescribing of branded agents, varies notably between infection types. What are the preferred agents by line of therapy for key infections due to MRSA, including cSSSIs/ABSSSIs, NP, and BSIs? What are the overall performance ratings of current and emerging brands? How do surveyed physicians rate the overall importance of key clinical attributes, and what is the performance of anti-MRSA agents on these individual attributes?

  • Three new anti-MRSA agents have entered the U.S. MRSA market since 2014, including Merck’s Sivextro, Allergan’s Dalvance, and The Medicines Company’s Orbactiv. What is physicians’ extent of current usage of these agents, and in which infection types? What is the receptivity of current non-prescribers to using these agents in the future, and how does it vary by treatment setting? Which agents are they most likely to displace?

Scope:

Markets covered: United States.

Primary research: 99 infectious disease specialists.

Indication coverage: Hospital- and outpatient-treated MRSA infections, including cSSSIs/ABSSSIs, nosocomial pneumonia (including hospital-acquired bacterial pneumonia [HABP], ventilator-associated bacterial pneumonia [VABP], and healthcare-associated pneumonia [HCAP]), bloodstream infections (BSIs), osteomyelitis/joint infections, implanted medical device infections, community-acquired bacterial pneumonia (CABP), complicated intra-abdominal infections (cIAIs), diabetic foot infections (DFIs).

Author(s): Brenda Perez-Cheeks, Ph.D.
Mladen Tomich, Ph.D.