Dificid Poised to Challenge Vancomycin Usage in the Treatment of Clostridium difficile Infection

Arlington Medical Resources (AMR) and BioTrends Research Group find that less than half of surveyed infectious disease (ID) specialists and only 6 percent of surveyed internists demonstrated unaided awareness of and familiarity with Dificid prior to its U.S. launch in mid-July. In LaunchTrends®Institutional: Dificid, AMR and BioTrends surveyed 100 U.S. ID specialists and internists about their current treatment practices for C. difficile infection (CDI) as well as their awareness, perceptions, and anticipated future use of Dificid.

Dificids sustained clinical response rate at 25 days following end of treatment is regarded by physicians as the drugs most significant advantage in the treatment of CDI. However, the cost of Dificid ($2,800 for a 10-day course) comes as a surprise to most surveyed physicians and is regarded as the most significant obstacle to the drugs use, including use in patients at hospital discharge and those in nursing home and long-term care facilities. Results from the study find that physicians are split regarding whether or not the cost of a 10-day course of Dificid outweighs its advantages.

"Early use of Dificid will likely be limited to patients with severe or severe/complicated disease and those experiencing recurrent, recalcitrant, or resistant infection," says AMRs vice president of research Danielle L. Drayton, PhD. "The cost of the drug is clearly seen by physicians as a barrier to use in the outpatient setting and in patients with their first episode of mild infection for which physicians prefer to begin treatment with less expensive and more established options."

The study also finds that oral vancomycin is the therapy most likely to be displaced by Dificid. However, the practice of compounding IV-based vancomycin for oral delivery will be a key barrier to Dificid replacement of vancomycin. Compounded IV-based vancomycin for oral delivery effectively represents generic vancomycin competition in the CDI market. Physicians report that use of IV-based vancomycin is common in their hospital and more often than not, their hospitals pharmacy automatically compounds IV vancomycin for oral delivery.