Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan 6;66(2):185-190.
doi: 10.1093/cid/cix773.

Antibiotic Expenditures by Medication, Class, and Healthcare Setting in the United States, 2010-2015

Katie J Suda  1   2 , Lauri A Hicks  3 , Rebecca M Roberts  3 , Robert J Hunkler  4 , Linda M Matusiak  4 , Glen T Schumock  2
Affiliations

Antibiotic Expenditures by Medication, Class, and Healthcare Setting in the United States, 2010-2015

Katie J Suda et al. Clin Infect Dis. .

Abstract

Background: Improving antibiotic use has the potential to decrease healthcare costs by reducing the incidence of antibiotic-resistant infections, antibiotic-associated adverse events, and expenditures due to unnecessary prescriptions. Antibiotic expenditures in 2009 totaled $10.7 billion in the United States. Since then, national and local antibiotic stewardship initiatives have grown. The purpose of this study was to assess trends in antibiotic expenditures by healthcare setting in the United States between 2010 and 2015.

Methods: Systemic (nontopical) antibiotic expenditures from January 2010 to December 2015 were extracted from the QuintilesIMS National Sales Perspectives database. These data represent a statistically valid projection of US medication purchases. Regression analyses evaluated trends in expenditures over the study period.

Results: Antibiotic expenditures totaled $56.0 billion over the 6-year period; the majority (59.1%) of expenditures were associated with the outpatient setting. Overall antibiotic expenditures in 2015 ($8.8 billion) were 16.6% lower than in 2010 ($10.6 billion). Antibiotic expenditures similarly decreased in the community by 25.5% (P = .05), but outpatient clinics and mail service pharmacy expenditures experienced significant growth (148% and 67% increase, respectively; P < .01 for both). In 2015, 16.5% of antibiotic expenditures in the community were for parenteral formulations, an increase of 25%.

Conclusions: From 2010 to 2015, antibiotic expenditures decreased. The majority of antibiotic expenditures were in the outpatient setting, specifically community pharmacies. Expenditures for intravenous agents in the community are increasing and may represent increased use. These results reinforce the importance of antibiotic stewardship efforts across the spectrum of healthcare.

Keywords: antibiotic; community; expenditures; outpatient parenteral antimicrobial therapy; stewardship.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. R. J. H. and L. M. M. are employees of QuintilesIMS. G. T. S. has served as a consultant or on advisory boards for AbbVie, Astellas, and CSL Behring for Dr Schumock in the past 3 years, but not for topics involving antimicrobials. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Antibiotic class expenditures stratified by healthcare setting, 2010–2015. Community pharmacies (gray background with white dots), mail service pharmacy (solid black), nonfederal hospitals (solid white), other nonretail (white and black checkerboard), clinics (solid dark gray). Denominator equals total dollars in the respective antibiotic class.
Figure 2.
Figure 2.
Annual proportion of antibiotic expenditures and percentage growth for parenteral formulations overall and by class in the community, 2014 (solid light gray) and 2015 (solid black). Community is defined as community pharmacies, mail order pharmacies, and clinics. For this analysis, oxazolidinones were grouped with the miscellaneous class.
See this image and copyright information in PMC

References

    1. Davey P, Brown E, Charani E, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev 2013; 4:CD003543. - PubMed
    1. Filice G, Drekonja D, Greer N, et al. Antimicrobial stewardship programs in inpatient settings: a systematic review. VA-ESP Project #09-009. Washington, DC: Department of Veterans Affairs, 2013. - PubMed
    1. Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. Prevalence of inappropriate antibiotic prescriptions among U.S. ambulatory care visits, 2010–2011. JAMA 2016; 315:1864–73. - PubMed
    1. Hecker MT, Aron DC, Patel NP, Lehmann MK, Donskey CJ. Unnecessary use of antimicrobials in hospitalized patients: current patterns of misuse with an emphasis on the antianaerobic spectrum of activity. Arch Intern Med 2003; 163:972–8. - PubMed
    1. Fridkin S, Baggs J, Fagan R, et al.; Centers for Disease Control and Prevention (CDC). Vital signs: improving antibiotic use among hospitalized patients. MMWR Morb Mortal Wkly Rep 2014; 63:194–200. - PMC - PubMed

MeSH terms

Substances