Antibiotic Expenditures by Medication, Class, and Healthcare Setting in the United States, 2010-2015

Abstract

Background Improving antibiotic use has the potential to decrease healthcare costs by reducing the incidence of antibiotic-resistant infections, antibiotic-Associated adverse events, and expenditures due to unnecessary prescriptions. Antibiotic expenditures in 2009 totaled 10.7 billion in the United States. Since then, national and local antibiotic stewardship initiatives have grown. The purpose of this study was to assess trends in antibiotic expenditures by healthcare setting in the United States between 2010 and 2015. Methods Systemic (nontopical) antibiotic expenditures from January 2010 to December 2015 were extracted from the QuintilesIMS National Sales Perspectives database. These data represent a statistically valid projection of US medication purchases. Regression analyses evaluated trends in expenditures over the study period. Results Antibiotic expenditures totaled 56.0 billion over the 6-year period; the majority (59.1%) of expenditures were associated with the outpatient setting. Overall antibiotic expenditures in 2015 (8.8 billion) were 16.6% lower than in 2010 (10.6 billion). Antibiotic expenditures similarly decreased in the community by 25.5% (P =.05), but outpatient clinics and mail service pharmacy expenditures experienced significant growth (148% and 67% increase, respectively; P