Guideline for Low-Cost Antimicrobial Use in the Outpatient Setting

Hansen, Lizbeth A.; Vermeulen, Lee C.; Bland, Sarah; Wetterneck, Tosha B.

doi:10.1016/j.amjmed.2006.06.012

Cited by 4 publications

(4 citation statements)

References 51 publications

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“…Al comparar los hallazgos con la literatura, se encuentra que la aplicación de la metodología Caracol es un aporte al conocimiento de la carga de la ec que complementa estudios anteriores y que es fácilmente aplicable al estudio de las familias colombianas de la Región Andina del país (37)(38)(39)(40)(41).…”

Section: Discussionunclassified

Carga financiera del cuidado familiar del enfermo crónico en la Región Andina de Colombia

Herrera¹,

Solarte²,

Restrepo³

et al. 2016

Rev. Cienc. Salud

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Section: Discussionunclassified

Carga financiera del cuidado familiar del enfermo crónico en la Región Andina de Colombia

Herrera¹,

Solarte²,

Restrepo³

et al. 2016

Rev. Cienc. Salud

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“…Hanson and colleagues have developed guidelines for prescribing low-cost antibiotics in outpatient settings that call for the use of first-line antibiotics for many common infections. 17 Many of these proposed treatments provide therapeutic value for less than $15 per prescription to cash-paying (uninsured) patients. 17 Interventions that have sought to change antibiotic prescribing patterns have their roots in inpatient or institutional settings and largely focused on decreasing antimicrobial resistance.…”

Section: What Is Already Known About This Subjectmentioning

confidence: 99%

“…17 Many of these proposed treatments provide therapeutic value for less than $15 per prescription to cash-paying (uninsured) patients. 17 Interventions that have sought to change antibiotic prescribing patterns have their roots in inpatient or institutional settings and largely focused on decreasing antimicrobial resistance. The Infectious Diseases Society of America outlines recommendations for the implementation of such interventions.…”

Section: What Is Already Known About This Subjectmentioning

confidence: 99%

Case Study of the Effects of Office-Based Generic Drug Sampling on Antibiotic Drug Costs and First-Line Antibiotic Prescribing Ratios

Conklin

Culley²

2009

JMCP

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R ising health care costs continue to prompt health plans, among other stakeholders, to identify and promote costeffective health care services. There is an inherent value in the promotion of lower-cost drug therapies (e.g., generic drugs) that achieve the same outcome as a higher-cost drug. 1 ABSTRACT BACKGROUND: Health plans and members benefit from the substitution of lower-cost drug therapies that achieve the same clinical outcomes as higher-cost drugs. Previous research suggests that generic sampling programs produce drug cost savings overall, but the effects attributable to acute therapies are unknown. Encouraging physicians to prescribe less expensive, first-line antibiotics may help reduce direct drug costs associated with prescribing potentially unnecessary, and more expensive, second-line agents.OBJECTIVES: To determine the effects of an automated, office-based generic drug sampling kiosk on (a) prescribing of first-line oral antibiotic agents as a ratio of total antibiotic prescribing and (b) average antibiotic drug cost per claim.METHODS: This managed care organization of 2.3 million members with pharmacy benefits collaborated with a vendor that developed an automated generic drug kiosk that allows for the dispensing of samples of generic medications within the prescriber's office. Among the samples contained in the kiosk were 6 generic, first-line oral antibiotics, representing 8 unique drug-strength options. Drug costs were defined as the ingredient cost of the drug claim, which includes plan cost, member cost share, and any dispensing fees or administrative program costs associated with the sampling program. In a difference-in-difference analysis, changes in outcome measures (antibiotic drug cost per claim and dispensing rates of first-line antibiotics) from 2003 (baseline year) to 2005 (post-implementation year) were compared among kiosk prescribers (n = 179) and nonkiosk prescribers who were part of the same provider network (n = 7,236). A cross-sectional analysis of the same outcome measures compared kiosk (n = 396) and nonkiosk prescribers (n = 10,267) in 2006. All statistical analyses were performed using t-tests of logtransformed data. for the nonkiosk prescribers, but the difference-in-difference analysis showed that the change was not statistically significant (P = 0.901). A cross-sectional analysis of 2006 data revealed significant differences between the kiosk prescribers versus their nonkiosk network counterparts for both first-line antibiotic prescribing rates (42.0% and 41.4%, respectively; P = 0.028) and antibiotic cost per claim ($28.44 and $32.40, respectively; P < 0.001). While the results of the cross-sectional analysis are statistically significant, the practical significance of the results is less evident.CONCLUSIONS: The benefits of including short-term medications such as first-line antibiotics in a generic drug sampling program are difficult to quantify, and the cost outcomes are unlikely on their own to justify generic drug sampling. However, acute (short-term) medications ...

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“…Appropriate medical and public health responses for this scenario might include optimisation of the use and supply of good-quality antimicrobials (e.g. development of guidelines for low-cost antimicrobial use in outpatient settings) [88]. Also important are improving diagnostic capability, active surveillance for antimicrobial resistance and emphasis on vaccination and locally costeffective infection control practices [40,45,58].…”

Section: Settings With Extreme To Moderate Resource Limitationmentioning

confidence: 99%

Antimicrobial resistance: international control strategies, with a focus on limited-resource settings

DiazGranados

Cardo

McGowan

2008

International Journal of Antimicrobial Agents

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Guideline for Low-Cost Antimicrobial Use in the Outpatient Setting

Cited by 4 publications

References 51 publications

Carga financiera del cuidado familiar del enfermo crónico en la Región Andina de Colombia

Carga financiera del cuidado familiar del enfermo crónico en la Región Andina de Colombia

Case Study of the Effects of Office-Based Generic Drug Sampling on Antibiotic Drug Costs and First-Line Antibiotic Prescribing Ratios

Antimicrobial resistance: international control strategies, with a focus on limited-resource settings

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