Yelp for Antibiotics: Effect of Providing Cost Data on Prescription of High-Cost Antibiotics

(1)Emory University School of Medicine, Atlanta, GA, (2)Emory University, Atlanta, GA, (3)ApolloMD, Atlanta, GA

Meeting: Hospital Medicine 2015, March 29-April 1, National Harbor, Md.

Keywords:

Background:

Physicians frequently prescribe antibiotics to inpatients without knowledge of medication cost. It is not well understood whether providing cost data would change prescribing behavior.

Methods:

To evaluate the effect of providing cost data alongside culture and antibiotic susceptibility results in two tertiary care hospitals, we conducted a quasi-experimental pre-post analysis. During a 12-month baseline period, no cost data was displayed. On May 26, 2010, cost category data for each antibiotic ($, $$, $$$, or $$$$) was added to culture and susceptibility testing results. We analyzed data from the following 12-month intervention period for changes in the average cost category of antibiotics prescribed to patients after the receipt of susceptibility testing results. 

Results:

There was a significant decrease in the average cost category of antibiotics per patient after the intervention (pre-intervention=1.9 $ vs. post-intervention=1.7 $, p=0.002). After adjusting for age, insurance type, and length of stay prior to antibiotic prescribing, the odds ratio (OR) of a patient’s average antibiotic cost being. $$$ or $$$$ vs. $ or $$ after the intervention was 0.55 (95% confidence interval (CI) 0.32, 0.95).

Conclusions:

Providing physicians with cost data alongside susceptibility testing data resulted in a significant decrease in prescription of high cost antibiotics. This intervention is easy to implement, low cost, and may shift providers towards lower cost medications when equally acceptable options are available.

To cite this abstract:

Newman K, Varkey J, Mohan A. Yelp for Antibiotics: Effect of Providing Cost Data on Prescription of High-Cost Antibiotics. Abstract published at Hospital Medicine 2015, March 29-April 1, National Harbor, Md. https://www.shmabstracts.com/abstract/yelp-for-antibiotics-effect-of-providing-cost-data-on-prescription-of-high-cost-antibiotics/. Accessed December 10, 2018.

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