Prescription Drug Prices Research Articles

POSB225 Differences and Similarities in the Methods: of Pricing of Prescription Drugs in Bulgaria, France, Germany, Belgium, and the UK: A Comparative Analysis

The objective of this study is to evaluate the methods of pricing of prescription drugs in selected countries. This study highlights some of the differences and similarities in pricing negotiation approaches in Bulgaria, France, Germany, Belgium, and the UK.

Strategic horizontal integration for drug cost reduction in the pharmaceutical supply chain

Recent increases in prescription drug prices have drawn the attention of lawmakers and the media. A 2018 report from the US Department of Health and Human Services indicated that prices of brand drugs increased six times faster than inflation from 2011 to 2015. Even the presence of generics may not reduce prices effectively. Over the last five years, Medicare spending on brand drugs increased by 77% even as usage fell (NBC News, 2018). Several studies also indicate that certain therapeutic classes of drugs are becoming expensive and may result in a long-term financial impact on Medicare Part D. This research considers how coordinated, drug-specific partnerships between independent chain and mail-order pharmacies may be leveraged to reduce drug costs and/or increase supply chain profit. Specifically, we develop an optimization model to determine how many and which of a chain pharmacy's regions should be set up to handle mail-order demand of particular drugs under the objective of maximizing total profit to the partners. Computational results illustrate the value of such partnerships for drug cost reduction and highlight the extent to which a unified effort can generate additional profits for both parties and thus impact pricing for click-and-collect customers.

How Do Commercial Insurance Plans Fare Under Proposed Prescription Drug Price Regulation?

How Do Commercial Insurance Plans Fare Under Proposed Prescription Drug Price Regulation?

Impact of a New Cost-Effectiveness Threshold Implementation on Cancer Formulary Decisions in Jordan.

Rising prices of novel cancer medications are increasing the economic burden from cancer in Jordan, risking the ability of cancer patients to access lifesaving and life-extending treatments. Furthermore, in the absence of a national health technology assessment (HTA) framework, medication prices in Jordan are set based on manufacturers’ pricing considerations and not a value proposition. In response to these challenges, King Hussein Cancer Center (KHCC), the de facto national cancer institute, developed a first-in-country, cancer-specific, cost-effectiveness threshold (CET) to aid institutional decision makers in approving only cost-effective medications. Over the past 10 years, cost-effectiveness analyses based on this CET have led to the introduction of > 70% of requested novel cancer medications after manufacturers agreed to lower prices, beyond registration prices, to meet the CET. Future work is warranted to empirically derive a CET for Jordan to better guide reimbursement decisions.Supplementary InformationThe online version contains supplementary material available at 10.1007/s41669-021-00293-4.

Payer-Specific Negotiated Prices for Prescription Drugs at Top-Performing US Hospitals

Payer-Specific Negotiated Prices for Prescription Drugs at Top-Performing US Hospitals

The orphan preparations: international approaches and national regulation

The medication support of patients with rare (orphan) diseases is an actual issue, since it requires significant financial costs due to high price of medications. The accessibility of these medications to such patients should be regulated by state incentives for development of orphan medications with following taking out to the market, by procedure of composing list of medications for treatment of orphan diseases and determination of financial support sources. The article considers aspects of regulation of issues related to orphan diseases and orphan medications in the Russian Federation and Europe. On the basis of regulated list of orphan diseases in Russia, the results of comparative analysis of list of orphan medications in Russia and list published at website of the European Union are presented. On the basis of data obtained, it was established that many medications for treatment of rare diseases registered in Europe are not available in Russia. Also, many orphan drugs in Europe do not have this status in Russia. At the same time, there are no state incentives for development of orphan medications in the Russian Federation, and there are only some benefits in registration procedure of such drugs. The analysis demonstrated availability of development and taking out to the Russian pharmaceutical market large list of orphan drugs from the European listing for National corresponding manufacturers.

Prescription Drugs Price Setting and Generic Drugs Prescription concerning Consumer Protection Law in Indonesia

<p>Health is one of the most important human rights in human life. Access to affordable prescription drugs is still a problem for people with out-of-pocket expenses. Generic prescription drugs that are much cheaper than non-generic drugs are still low, especially in non-government healthcare facilities. This research aims to provide suggestions of regulation on price control of prescription drugs and generic prescription drugs that will assure certainty and affordability for the public. The methodology is doctrinal legal research and is supported by empirical studies. The research finding consist of two things, namely the price of prescription drugs and the prescription of generic drugs. The first finding is that Highest Retail Price (HET) set by the manufacturer is potentially to be unlimited because there is no limit control. Currently, there are many drugs sold over HET with minimal supervision from the Government. The absence of law is found as the existing regulations are only for those listed in the National Formulary, while the rest have not been regulated. Therefore, the suggestion is to set ceiling prices for prescription drugs with comparison among generic drugs, branded generic drugs, and the originator; also create a refund mechanism for prices above HET to assure the consumers’ rights to get compensation under the Consumer Protection Law. The second finding is that only a few doctors prescribe generic drugs. Additionally, patients have not been involved in the treatment decisions.Therefore, the suggestion is to associate "the action of prescribing generic drugs" with the extension of doctor's license, namelythe Registration Certificate (STR); so that doctors will prescribe generic drugs without the need for close supervision due to their interests. With the increase of generic drugs’ prescription, the financing of health services, nationwide as well asindividually, can become more affordable.</p>

TP8.2.18 Every little helps. A trainee led cost saving initiative

Abstract Aim The NHS is under pressure to deliver the best quality care within a confined budget. The cost of spending on medications is growing by 12% per annum. The five year forward plan for the NHS called for £22 Billion in efficiency savings. All NHS staff are being asked to help deliver better outcomes at lower costs. We aimed to review costs in the surgical department, identify savings, implement changes and evaluate the outcome. Method Pharmacy orders from 2016-17 were reviewed. Prices of branded and generic medications were compared. Levobupivicaine was identified as a product with cost savings between branded and generic forms. Procurement officers were advised to switch to generic alternatives and the pharmacy system was adjusted to highlight that generic forms should be ordered. Orders for 2018-19 were reviewed and savings calculated. Results 29,280 units of levobupivicaine were ordered in 2016-17. 100% of these orders were of the branded product. Projected savings of switching to a generic product was £12,846 per annum. 31,355 units of levobupivicaine were purchased during the 2018-19 period. 83% of orders were for the generic product. £11,805 was saved over this period. £1,703 of further savings have been highlighted. Conclusion We have shown that simple changes can result in modest savings. All NHS staff, including trainees, can lead cost reducing initiatives. Multiple small savings will summate to larger savings, resulting in resources being better utilised to improve patient outcomes.

A Comparison of Pharmaceutical Prices for Generic Erectile Dysfunction and Benign Prostatic Hyperplasia Medication in 2 Socioeconomically Disparate New York City Neighborhoods.

Erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) are frequently managed with medications. Variability and poor understanding of medication prices have been shown to hinder patient adherence, leading to worse clinical outcomes. We sought to explore how pharmacy type and neighborhood socioeconomic status influence pricing for generic ED and BPH medications. A total of 96 pharmacies within the adjacent higher income Upper East Side (UES) and lower income East Harlem (EH) New York City neighborhoods were classified as chain or independent. Telephone surveys identified cash prices for 30-day supplies of 14 medications including phosphodiesterase 5-inhibitors, 5-alpha reductase inhibitors, alpha blockers and antispasmodics. Pricing variability based on pharmacy type and neighborhood was evaluated using Mann-Whitney U-tests. Of 96 pharmacies, 81 responded (84.4%). Independent pharmacies showed significantly reduced prices for 9/14 and 14/14 medications in UES and EH, respectively. The greatest independent pharmacy price reductions were for tadalafil 20 mg (15.0-fold in UES, 26.7-fold in EH) and sildenafil (8.4-fold in UES, 15.4-fold in EH). The least significant reductions were in mirabegron (1.1-fold in UES, 1.2-fold in EH). Independent pharmacies in EH showed lower prices for 9/14 medications compared to those in UES. Across both neighborhoods, independent pharmacies offered consistently lower cash prices for ED and BPH medications. Lower independent pharmacy prices in the lower income EH neighborhood suggest that neighborhood socioeconomic status may impact pricing. Physicians and patients alike must understand the factors that influence pricing to ensure more optimal patient compliance for uninsured patients.

Behavioral economics strategies for promoting adherence to treatment in heart failure patients

Abstract Heart failure (HF) is characterized by an increased risk of both fatal and nonfatal adverse cardiovascular events, which required life-long and costly treatment. At the same time every cardiology practitioner is well aware, that despite huge efforts on patient's education there remains a substantial part of patients who do not always make rational choices regarding their treatment. Patient's knowledge does not always translate into adherence, so we must find ways to minimize the intent-behavior gap to improve the efficacy of HF treatment. We presume that behavioral economics can provide us with tools that will promote positive present behavior of patients. The purpose of the study was to examine the utility of behavioral economics-related concepts in understanding long-term treatment strategy in heart failure patients and acute heart failure survivors. Methods We performed an open prospective study involving male patients with both chronic and acute heart failure (CHF n=65 and AHF n=54). Involved patients were surveyed on symptom severity, behavioral economics “parameters”. Cognitive complexity was measured via “real life” case simulations. We assessed stress and depression with HADS and Zung's scales serially: on admission, 3d day of hospitalization and day before discharge. In patients with AHF, first assessment was performed after clinical stabilization. The primary outcomes were set as an adherence to prescribed medication assessed 6 and 36 months after discharge, rehospitalization due to cardiovascular reasons and self-assessed well-being. Results We observed opposite patterns of stress dynamics in CHF and AHF groups. AHF patients demonstrated significant reduction of stress level on the 3d day since admission: 9.0 (7.1; 9.9) vs 6.4 (5.7; 7.4) units, p=0.037, with further increase at discharge, while in CHF patients there was tendency to significant change in parameter was absent. Patients who survived AHF demonstrated higher 6 month adherence to prescribed medication (62.9% vs 49.2%, p=0.047), at the same time there was the strong positive correlation between medication's price and self-induced therapy interruption (R=0.74, p<0.05). Both AHF and CHF reported financial planning as the major contributor for decision making in “real life” cases. Surprisingly in study population self-assessed well-being did not correlated with rehospitalization rate. Parameters that were significantly associated with CV rehospitalization included symptoms at admission (OR 2.1 CI 1.4; 3.2, p=0.002), regularly saving money (OR =2.7 CI 1.9; 4.6, p=0.001) and stress level at discharge (OR 1.6 CI 1.1; 2.4, p=0.027). Conclusion Received results may be useful to identify heart failure patients at higher risk of self-induced treatment interruption. These patients could be offered focused support and counseling designed to enhance adherence to prescribed medication in order to improve long-term heart failure outcomes. Funding Acknowledgement Type of funding sources: None.

MP28-02 WHAT FACTORS INFLUENCE BPH MEDICATION PRICING? A STUDY OF CHAIN, INDEPENDENT, AND ONLINE PHARMACIES IN ADJACENT, SOCIOECONOMICALLY DISPARATE NEIGHBORHOODS IN NEW YORK CITY

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation (MP28)1 Sep 2021MP28-02 WHAT FACTORS INFLUENCE BPH MEDICATION PRICING? A STUDY OF CHAIN, INDEPENDENT, AND ONLINE PHARMACIES IN ADJACENT, SOCIOECONOMICALLY DISPARATE NEIGHBORHOODS IN NEW YORK CITY Micah Levy, Evan B. Garden, Nir Tomer, Osama Al-Alao, Alexander C. Small, and Michael A. Palese Micah LevyMicah Levy More articles by this author , Evan B. GardenEvan B. Garden More articles by this author , Nir TomerNir Tomer More articles by this author , Osama Al-AlaoOsama Al-Alao More articles by this author , Alexander C. SmallAlexander C. Small More articles by this author , and Michael A. PaleseMichael A. Palese More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002025.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: First-line management of benign prostatic hyperplasia (BPH) involves medication therapy. However, variability and poor understanding of medication prices can hinder patient adherence, leading to worse clinical outcomes. We explored how pharmacy type and neighborhood socioeconomic status influences out-of-pocket pricing for common, generic BPH medications in two socioeconomically disparate neighborhoods in New York City. METHODS: All pharmacies in the Upper East Side (UES) and East Harlem (EH) were classified as chain (CP) or independent (IP). 96 pharmacies (CP:29, IP:67) were identified. Six mail order pharmacies (Amazon, Capsule, Blink Health, Honeybee, Genius RX, and Health Warehouse) were classified as online pharmacies (OP). Phone calls to local pharmacies were placed, and publicly accessible online data was recorded to obtain out-of-pocket, cash prices for 30-day supplies of 12 common BPH medications (Table 1). Median drug prices were compared based on pharmacy type and neighborhood. RESULTS: 81/96 (84.4%) of UES and EH pharmacies responded (CP:29 [35.8%], IP:52 [64.2%]). IP had significantly cheaper prices than CP in 8/12 medications in the UES and in 12/12 medications in EH. OP had significantly cheaper prices than CP in 11/12 medications in both UES and EH. 2/11 medications showed significantly lower prices in OP than in IP in the UES. No differences were found between OP and IP in EH. Dutasteride had the greatest differences between CP and IP (6.07x in UES, 8.87x in EH) and between CP and OP (8.25x in UES, 8.05 in EH) (Table 1a). OP and CP had standardized prices independent of location. IP showed significantly higher prices for 9/12 medications in the UES than in EH, with up to 2.00x higher prices (Table 1b). CONCLUSIONS: Regardless of neighborhood, both IP and OP offered consistently lower BPH medication prices compared to CP. Lower IP prices identified in the lower income EH neighborhood suggest that a location’s socioeconomic status can impact BPH medication prices. Medication pricing can be highly variable; therefore, physicians and patients alike must understand the factors that influence medication pricing to ensure optimal patient outcomes. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e480-e481 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Micah Levy More articles by this author Evan B. Garden More articles by this author Nir Tomer More articles by this author Osama Al-Alao More articles by this author Alexander C. Small More articles by this author Michael A. Palese More articles by this author Expand All Advertisement Loading ...

International reference pricing for prescription drugs: a landscape analysis.

During the Trump administration, members of Congress and the administration proposed the introduction of international reference pricing (IRP) to Medicare in order to reduce US drug spending by benchmarking prices to those in other countries. Many other countries currently use IRP. We examined how US policy proposals compare with the implementation of IRP in the countries that would be referenced by the United States. Nearly two-thirds of comparator countries use IRP but also use other price negotiation strategies. The congressional proposal was most like the approach used by other countries, while the Trump administration's proposals took an uncommon approach to IRP by not adopting additional pricing strategies. DISCLOSURES: This work was supported by Arnold Ventures, which provided overall funding but was not involved in conception, design, or conduct of this work. Kesselheim provides guidance to the Massachusetts Health Policy Commission on its prescription drug price review process under a contract to Brigham and Women's Hospital but does not receive personal funding for this work. Rand has nothing to disclose.

Learning From Novel Approaches to Paying for Hepatitis C Virus Medications in State Medicaid Programs

In the absence of notable action by the US Congress to address rising prescription drug prices, many states have moved to fill the gap.1 State Medicaid programs, which finance 10% of outpatient prescription drug spending, have recently adopted innovative approaches to paying for prescription drugs.

Pursuing Value-Based Prices for Drugs:A Comprehensive Comparison of State Prescription Drug-Pricing Boards.

Rising prescription drug costs are consuming a growing proportion of state and private budgets. In response, lawmakers have experimented with a variety of policies to contain spending and achieve value in prescription drugs. As part of this series of reforms, some state legislatures have recently authorized prescription drug-pricing boards to address the high prices of brand-name prescription drugs and assess the value of those drugs. We identified state prescription drug-pricing boards in the United States, defined as any agency authorized by a state legislature to review specific drugs and pursue value-based drug prices. To describe the characteristics of the boards, we obtained public records of authorizing legislation, guidance documents, and board meeting minutes. We compared the boards' powers and responsibilities and analyzed completed pricing reviews. Six state drug-pricing boards in five states met our definition; their design varied substantially. Two of the boards (New York Medicaid and Massachusetts) have authority over drug rebates paid by state Medicaid programs, one (New York Drug Accountability Board) has jurisdiction over state-regulated commercial insurance, and another three (Maine, Maryland, and New Hampshire) oversee non-Medicaid, state-funded insurance. Three boards are authorized to require manufacturers to confidentially submit information related to the pricing and clinical effectiveness of reviewed drugs to inform value determinations. Only one board (New York Medicaid) had completed pricing reviews as of June 3, 2021. Boards' structure, scope, and statutory leverages to compel manufacturers to negotiate lower net costs are key factors that influence whether and to what extent boards can achieve cost savings for states. Though legal constraints may limit the effective reach of prescription drug-pricing boards, these agencies can enable states to address rising prescription drug costs, in part by virtue of their very existence. To overcome practical limitations, states seeking to implement similar policies can build on the experiences and designs of current boards.

Leveling the Playing Field: Industrial Policy and Export-Contingent Subsidies in India–Export Related Measures

AbstractIn India–Export Related Measures, the United States challenged a range of Indian measures as prohibited export-contingent subsidies, and a WTO panel largely agreed. This article examines the factors at play in the United States’ decision to bring the challenge. At the level of policy, the United States case reflects India's graduation from the protections afforded developing nations’ export-contingent subsidies under the Agreement on Subsidies and Countervailing Measures. A closer examination, however, shows that India ramped up its export-contingent subsidies just as the SCM Agreement required it to wind those subsidies down. Moreover, the expanded Indian subsidies led to increased import competition with the politically influential metals and pharmaceutical sectors in the United States, which pushed the US challenge. We reflect on the larger implications of the challenge for the future of trade rules on industrial policy. In particular, we note that the United States pursued a trade enforcement policy that would have the effect of increasing pharmaceutical prices in the United States, by reducing subsidies for imported generic drugs, at a time when the Trump administration allegedly was trying to reduce the price of prescription drugs. This disconnect suggests the need for both greater transparency in trade policy and greater governmental coordination on the connection between trade policy and other policy priorities.

The Burden of Unavailable Drugs Cost to Patients Admitted to Internal Medicine Ward of Tikur Anbessa Specialized Hospital.

PurposeTo assess the burden of unavailable drugs cost to patients admitted to TikurAnbessa Specialized Hospital’s internal medicine ward. Costs of medications obtained inside and outside the pharmacy and other burdens associated with drugs’ unavailability are also estimated and explored.Patient and MethodsA facility-based cross-sectional study design was conducted from November 9 to November 23, 2020. Quantitative data on medication costs were collected from patients admitted to TikurAnbessa Specialized Hospital internal medicine ward B8. Qualitative information was collected from patients, caregivers, and health care professionals through interviews to assess the burdens of unavailability of pharmaceuticals on patients and the health care system.ResultsA total of 32 patients were enrolled in the study. Participants’ age ranged from 14 to 92. Eighteen (56.25%) paid in cash for medications bought within the hospital pharmacy, while the remaining 14 (43.75%) were treated for free. A total of 68 medicines were prescribed during the study period. Of this, 33 (48.53%) medicines were not available in the hospital pharmacy. The total costs of patients were 78.07$ and 1530.84$ when purchased from inside and outside the hospital pharmacy, respectively. The average price of medications per patient ranged from 0.025 to 8.41$ inside the hospital pharmacy, where the average cost per patient outside the hospital pharmacy ran from 0.128 to 54.67$. For the qualitative part, four patients and/or caregivers and five health care professionals were interviewed, and three key themes emerged from the thematic analysis: (i) awareness of the availability of medication, (ii) management of the burden of stock out, and (iii) impact of the stock out.ConclusionThe study came up with a result that the hospital pharmacy has high unavailability of medication. Patients complain about unwanted and unreasonably expenditure to purchase pharmaceuticals from outside pharmacies and associated delayed treatment.

Severe Allergies, Price Increases, and Supply Shortages

Controlling pharmaceutical prescription costs has been an interest in the United States for decades. In 2016, EpiPen experienced a 600% price increase. This exploratory framing study focuses on news coverage of EpiPen’s price increase and related pharmaceutical price increase stories through analyzing three U.S. television news programs’ coverage. Within 30 news segments that discussed EpiPen or medication price increases, analysis revealed four frames: economic, attribution of responsibility, morality and human interest, and conflict and powerlessness. This study provides a larger understanding of how the crisis of medication price increases is understood and implications for practitioners and individuals aiming to make medications more accessible.

COVID-19 Pandemic’s Impact on Medication Dispensing and the use of Health Services in Makkah, Saudi Arabia

Aims: March 2020, WHO revealed that COVID-19 was a pandemic. Coughing, sneezing, close contact with infected individuals speeds up the disease spread. Saudi Arabia's government and the Ministry of Health sought to spread social awareness of the importance of quarantine and restriction, but unprecedented challenges and obstacles emerged. Therefore, in this study, the effect of COVID-19 on the dispensing of medication and the use of health care services evaluated.
 Study design: This survey, cross-sectional, was performed in Makkah city individuals.
 Place and Duration of Study: This survey was run out in Makkah city, Saudi Arabia for seven days, starting from June 15, 2020, to June 22, 2020.
 Methodology: Survey of 112 applicants (33 men, 79 women; age range 16-56+ years) had been performed to explore COVID-19 impact on medication dispensing and the use of health care services regarding sociodemographic data in Makkah city residents, Saudi Arabia.
 Results: This study demonstrated that most of the survey respondents coped well with COVID-19 changes. A significant correlation was found between coping with COVID-19 changes and the age of participants (F(df) = 7.846 (4,107), P-value 0.006) and (F(df) = 4.025 (4,107), P-value 0.047), respectively. Of all the participants, 68.75% had been able to dispense a prescription medication during COVID-19 restrictions. Among them, 30.36, 21.43, and 16.96% dispensed a prescription once, twice, and more than three times, respectively. The data showed that 67.86% of the participants successfully purchased medication from a community pharmacy during COVID-19 restrictions. There was no change in medication availability or price, at about 61.61% and 76.79%, respectively. A significant correlation between medication availability-price (F(df) = 4.025(3,105), P-value 0.047) was found. During COVID-19 restrictions, 51.79% of the respondents were able to access health care services such as hospitals that provide health checking, or substance use for disease treatment. Interestingly, 25% of the participants had the same accessibility to health care services.
 Conclusion: This research revealed that through the COVID-19 pandemic, the dispensing, availability, and price changes of medication and the use of health care services were running in a good manner. This would show that although there were restrictions due to COVID-19, access to medication or health care services was running smoothly.

The impacts of government reimbursement negotiation on targeted anticancer medication price, volume and spending in China

IntroductionNew targeted therapies have changed cancer treatment in the past decades. However, high prices of targeted anticancer medications have increased economic burden for both patients and health insurance systems. In...

Skin infections due to Panton-Valentine leukocidin (PVL)-producing S. aureus-Cost effectiveness of outpatient treatment.

IntroductionSkin and soft tissue infections (SSTI) caused by Panton-Valentine leukocidin (PVL)-producing strains of Staphylococcus aureus (PVL-SA) are associated with recurrent skin abscesses. Secondary prevention, in conjunction with primary treatment of the infection, focuses on topical decolonization. Topical decolonization is a standard procedure in cases of recurrent PVL-SA skin infections and is recommended in international guidelines. However, this outpatient treatment is often not fully reimbursed by health insurance providers, which may interfere with successful PVL-SA decolonization.AimOur goal was to estimate the cost effectiveness of outpatient decolonization of patients with recurrent PVL-SA skin infections. We calculated the average cost of treatment for PVL-SA per outpatient decolonization procedure as well as per in-hospital stay.MethodsThe study was conducted between 2014 and 2018 at a German tertiary care university hospital. The cohort analyzed was obtained from the hospital’s microbiology laboratory database. Data on medical costs, DRG-based diagnoses, and ICD-10 patient data was obtained from the hospital’s financial controlling department. We calculated the average cost of treatment for patients admitted for treatment of PVL-SA induced skin infections. The cost of outpatient treatment is based on the German regulations of drug prices for prescription drugs.ResultsWe analyzed a total of n = 466 swabs from n = 411 patients with recurrent skin infections suspected of carrying PVL-SA. PVL-SA was detected in 61.3% of all patients included in the study. Of those isolates, 80.6% were methicillin-susceptible, 19.4% methicillin-resistant. 89.8% of all patients were treated as outpatients. In 73.0% of inpatients colonized with PVL-SA the main diagnosis was SSTI. The median length of stay was 5.5 days for inpatients colonized with PVL-SA whose main diagnosis SSTI; the average cost was €2,283. The estimated costs per decolonization procedure in outpatients ranged from €50-€110, depending on the products used.ConclusionOur data shows that outpatient decolonization offers a highly cost-effective secondary prevention strategy, which may prevent costly inpatient treatments. Therefore, health insurance companies should consider providing coverage of outpatient treatment of recurrent PVL-SA skin and soft tissue infections.