Long-acting glycopeptides: what are the barriers to access in patients who need them most, and how can they be overcome?

Long-acting glycopeptide antibiotics (LGPs), such as dalbavancin and oritavancin, are a novel class of antibiotic agents effective in the treatment of Gram-positive infections. The long half-life and relative ease of administration of LGPs make them a valuable treatment option for patients experiencing barriers to healthcare access. However, challenges for effective use remain, and disproportionately affect patients who would most benefit. These include high upfront costs, cost siloing, impractical and inconsistent medication approval processes and limited integration into existing multidisciplinary models of care. There is a clear need to improve funding arrangements, institutional workflows and models of care to promote safe and equitable access to LGPs, in line with processes developed for other high-cost medications.