Antimicrobial drug cost and effect of antimicrobial restriction policy

Abstract

Irrational antimicrobial use causing rise of antimicrobial resistance and more severity of diseases, leading to high expenditures. Hospital was implied restriction policy in order to accomplished rational drug use. The aims of this study were to determine antimicrobial cost and to evaluate the effect of antimicrobial restriction policy at Mahasarakham Hospital. The retrospective study was conducted and data collected for the fiscal year 2010 - 2013 by on - line database. Result shown that antimicrobial cost were 50.68, 65.18 and 55.35 million baht in 2010 - 2013, respectively. Cost increased to 28.61% in 2012 but decreased by 15.08% in 2013 from 2012. Cephalosporins, Cephamycins and other beta-lactams group, the highest cost group along three fiscal year were 28.76, 33.59 and 28.12 million baht (56.76%, 51.53% and 50.80%) In 2012 cost in this group increased to 16.77% but decreased by 16.29% in 2013. Imipenem 0.5 g, cilastatin 0.5 g injection and Sulbactam 0.5 g, cefoperazone 1 g injection were high cost in the group. In-patient, antimicrobial cost was 92.40%, 94.30% and 93.30% of total antimicrobial cost in 2011 - 2013, respectively. The restriction policy implemented in 2013 for 19 medications. Four medications were volume increased and increased to 16.86% in cost, eleven medications were volume decreased and decreased by 34.82% (10,176,075.24 baht) in cost. Three medications were volume increased but cost decreased by 18.58%. Only one medication was increased in cost but volume decreased. Changing three medications from original to generic medications reduced cost to 6,586,482.40 baht (11.90%)
Conclusion, antimicrobial cost and consumption decreased by objectively implement of restriction policy and monitoring.