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.
