146. Antibiotic Expenditures by Medication Class and Healthcare Setting in the United States, 2010-2013
Session: Poster Abstract Session: Antimicrobial Stewardship: Current State and Future Opportunities
Thursday, October 8, 2015
Room: Poster Hall
  • Suda-IDSAPoster_FINAL.pdf (714.8 kB)
  • Background:

    Improving antibiotic use has the potential to decrease health care costs by reducing the incidence of antibiotic-resistant infections, antibiotic-associated adverse events, and expenditures due to unnecessary prescriptions. We first reported that antibiotic expenditures totaled $10.7 billion in 2009 in the United States. The purpose of this study was to assess overall and class-specific antibiotic costs by health care setting in the United States between 2010 and 2013.


    Systemic antibiotic expenditures from January 2010-December 2013 were extracted from IMS Health© National Sales Perspectives database.  These data represent a statistically valid projection of inpatient and outpatient medication purchases in the U.S. 


    RESULTS:  Antibiotic expenditures totaled $38.0 billion over the study period; expenditures in 2013 ($9.2 billion) were 13.3% lower than in 2010 ($10.6 billion). The majority (60.4%; $22.9 billion) of expenditures were associated with the outpatient setting; 89.8% of outpatient expenditures were in community pharmacies. Non-federal hospitals accounted for 29.1% of expenditures. From 2010 to 2013, the largest growth in antibiotic expenditures occurred in mail order pharmacies (71.3% increase) and clinics (39.9% increase). The antibiotic class accounting for the largest proportion of antibiotic expenditures overall was the tetracyclines, followed by penicillins, cephalosporins, and macrolides. The majority of expenditures for tetracyclines (83.8% of tetracycline expenditures), sulfamethoxazole/trimethoprim (74.6%), macrolides (73.7%), quinolones (73.3%), and cephalosporins (65.2%) were in community pharmacies.


    The outpatient setting, especially community pharmacies, are where most (>60%) antibiotic expenditures are incurred. Outpatient antibiotic expenditures are likely a very conservative estimate of the relative contribution to U.S. antibiotic consumption, as intravenous formulations are more expensive than oral formulations. Other countries with comprehensive use data have reported that 90% of antibiotic use is in the outpatient setting. These results suggest an opportunity for antimicrobial stewardship efforts to reduce drug expenditures.

    Katie Suda, PharmD, M.S.1, Lauri Hicks, DO2, Rebecca M. Roberts, MS2, Robert Hunkler, RPh3, Linda Matusiak, M.S.4 and Glen Schumock, PharmD, MBA, PhD1, (1)University of Illinois at Chicago, Chicago, IL, (2)Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, (3)IMS Health, Plymouth Meeting, PA, (4)IMS Health, Plymouth meeting, PA


    K. Suda, None

    L. Hicks, None

    R. M. Roberts, None

    R. Hunkler, Ims health: Employee , Salary

    L. Matusiak, Ims health: Employee , Salary

    G. Schumock, Abbvie: Consultant and Grant Investigator , Consulting fee and Grant recipient
    Baxter: Consultant and Grant Investigator , Consulting fee and Grant recipient
    Merck: Consultant and Grant Investigator , Consulting fee and Grant recipient
    Transdermal therapeutics: Consultant and Grant Investigator , Consulting fee and Grant recipient

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