Prescription for Change

Are you seeing cost savings from antibiotic stewardship?

by Gina Lohr and Samm Freedman

By now, you’ve surely seen the data. 20-50% of prescribed antimicrobials in the U.S. are unnecessary or inappropriate. This contributes to developing antibiotic-resistant bacteria, which infects 2 million people, causes 23,000 deaths, and costs the health care system as much as 20 billion dollars each year. A single case of the drug-resistant fungus Candida can result in 3-13 additional days of hospitalization and incur a total of $6000-$29,000 in direct health care costs.

Antimicrobial stewardship programs save hospitals money

In 2014, the Centers for Disease Control and Prevention (CDC) recommended that hospitals incorporate antimicrobial stewardship programs (ASPs) into all acute care settings. ASPs promote a partnership between pharmacy services and clinical care teams to steer physician prescribing behavior and track antimicrobial resistance patterns. These programs optimize patient safety and reduce the spread of multi-drug resistant organisms, minimizing the likelihood of adverse drug events and reducing unnecessary hospitalizations.

As a result, successful ASPs have demonstrated a 22%-36% reduction in antibiotic use and an annual savings of $200,000-$900,000 across both large academic and small community hospitals.

The Centers for Medicare and Medicaid Services (CMS) plan to strengthen stewardship requirements in the coming years for hospitals participating in Medicare. Unfortunately, most hospitals are far from this goal. Small hospitals often face the biggest challenges in establishing an ASP due to a lack of infectious disease-trained physicians and pharmacists to lead stewardship efforts.

Making antibiotic stewardship work 'in real life'

The Physician Executive Council, along with the Pharmacy Executive Forum, has developed resources to help you implement an ASP that works within your hospital or health system. We recommend passing them along to your physician and pharmacy leaders responsible for antibiotic stewardship and quality outcomes.