Effects of economic and health policies on the consumption of antibiotics in a Spanish region

García, Paula Rojas; Villar, Fernando Antoñanzas

doi:10.1080/14737167.2019.1647105

Cited by 8 publications

(8 citation statements)

References 17 publications

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“…26 Advanced age and the existence of comorbidities are conditions that lead to a high risk of hospitalization and mortality rate due to COVID-19 infection. 27 In addition to clinical determinants, it has been detected that the incidence of COVID-19 is related to economic variables and it increases as the patient's income level or neighbourhoods wealth decreases. [28][29][30] No significant differences were found by age groups in the DID prescribed in February 2020 compared to the same month 2019, neither in women nor in men.…”

Section: Discussionmentioning

confidence: 99%

“…26 In a previous study, it was concluded that other economic and clinical measures, such as an increase in co-payment rates and the implementation of awareness and rational antibiotic use campaigns, have also reduced antibiotics consumption but at a lower rate (around an −8% and a −5%, respectively). 27 However, it was reported that the effect of co-payment disappeared over time and could not be implemented periodically. Also, co-payment reduces the intake of all medicines due to an increase in the price borne by patients.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of the Prescription of Antibiotics During the Implementation of COVID-19 Personal Protection Measures in a Regional Health System

Rojas-Garcia¹,

Antoñanzas²

2021

CEOR

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Analysis of the Prescription of Antibiotics During the Implementation of COVID-19 Personal Protection Measures in a Regional Health System

Rojas-Garcia¹,

Antoñanzas²

2021

CEOR

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“…The significant decrease in antibiotic use observed from 2009 (4.39%) to 2011/2012 (3.34%) may be due to the economic crisis that affected Spain from 2008 to 2013 [41], which led to the reduction of the purchasing power of elderly persons and the prescriptions were more closely controlled. Some authors have noted a decrease in the antibiotic consumption during that period [42]. After the economic crisis, in Spain, in 2014, there was an increase in the percentage of urinary and respiratory tract infections with respect to the period from 2009 to 2013 (16.7% and 11.1% increase, respectively) [43], which could explain the significant spike in antibiotic consumption observed in 2014.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Determinants of Antibiotic Consumption in the Elderly during 2006–2017

Cruz

Cebrino

2020

IJERPH

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Elderly people are a particularly important population with regard to antibiotic overuse, using around 50% more antibiotics per capita than younger adults. The aim of this study was to analyze the prevalence, associated factors and evolution over time of antibiotic consumption among the Spanish population aged ≥ 65 years from 2006 to 2017. A descriptive cross-sectional study was conducted using data from the Spanish National Health Survey in 2006, 2011/2012 and 2017, and from the European Health Survey in Spain in 2009 and 2014. The sample consisted of 26,891 non-institutionalized individuals ≥ 65 years. Antibiotic consumption was the dependent variable, and sociodemographic variables, lifestyle habits and health status were analyzed using a logistic regression model. The prevalence of antibiotic consumption was 4.94%, with a marked increase from 2006 (4.64%) to 2017 (5.81%) (p < 0.0001). Higher antibiotic consumption was associated with poor or very poor self-perceived health status, no polypharmacy and not having been in hospital during the previous twelve months, while a lower consumption was linked to being limited but not severely due to a health problem and not being at all limited.

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“…In a study undertaken in Belgium, it was found that consumption of antibiotics was reduced by 12.8% DID after an antibiotic awareness campaign was implemented [35]. In other Spanish Regional Services, the consumption of antibiotics was reduced by 5% (both packages and expenditure) after an awareness and rational use campaign was introduced [36]. The first available data on the consumption of antibiotics in Spain coincide with the approval of the PRAN in 2014.…”

Section: Discussionmentioning

confidence: 99%

Policies to Reduce Antibiotic Consumption: The Impact in the Basque Country

Rojas

Antoñanzas

2020

Antibiotics

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In 2013, a change in copayment rate was introduced in the Basque Country (one year later than in the other regions in Spain), and improvements were made to drug packaging. In 2014, a National Program Against Bacterial Resistance (Spanish abbreviation: PRAN) was approved. The aim of this study is to analyze the impact of change to the copayment rate, the adjustment of drug packaging, and the approval of PRAN on the consumption of antibiotics. Raw monthly data on the consumption of antibiotics (costs, packages, and daily defined doses per thousand people (DID)) were collected from January 2009 to December 2018 in the Basque Country. Counterfactual and intervention analysis (Autoregressive integrated moving average (ARIMA) model) was performed for the total series, disaggregated by group of antibiotics (2019 WHO Access, Watch, and Reserve (AWaRe) Classification) and active substances with the highest cost per prescription (cefditoren and moxifloxacin), the lowest cost per prescription (doxycycline and cloxacillin), and the most prescribed active ingredients (amoxicillin, azithromycin, and levofloxacin). Introduction of copayment led to a ‘stockpiling effect’ one month before its implementation, equal to 8% in the three consumption series analyzed. Only the adjustment of drug packaging significantly reduced the number of packages dispensed (−12.19%). PRAN approval reduced consumption by 0.779 DID (−4.51%), representing a significant decrease for both ’access’ and ’watch’ group antibiotics. Despite the delay in implementing changes to copayment, there was a ‘stockpiling effect’. With the adjustment of packaging, fewer packs were prescribed but with a higher drug load and price. PRAN approval reduced both the consumption of ’access group antibiotics’ (first-line treatment) and ’watch group antibiotics’ (second-line treatment).

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Effects of economic and health policies on the consumption of antibiotics in a Spanish region

Cited by 8 publications

References 17 publications

Analysis of the Prescription of Antibiotics During the Implementation of COVID-19 Personal Protection Measures in a Regional Health System

Analysis of the Prescription of Antibiotics During the Implementation of COVID-19 Personal Protection Measures in a Regional Health System

Prevalence and Determinants of Antibiotic Consumption in the Elderly during 2006–2017

Policies to Reduce Antibiotic Consumption: The Impact in the Basque Country

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