Cost-Benefit Analysis of Antimicrobial Stewardship Program in Women’s Health at Hamad Medical Corporation in Qatar

Background

• It is estimated that half of all antimicrobial agents prescribed are either unnecessary or inappropriately used
• In Qatar, a survey revealed that approximately 82% of people used antibiotics without a prescription, and 45% did not complete their antibiotic courses
• It is undisputed that the emergence of antimicrobial resistance is detrimental to not only health and wellbeing but also the healthcare system
• There is a lack of solid evidence to adequately inform decision makers seeking optimal allocation of resources in relation to antimicrobial stewardship programs (ASPs)

Objective

• To estimate the economic impact of premature ASP use versus mature ASP use in the women’s health settings in Qatar

Methods

• The study is a retrospective review of the patients who received any of the targeted antimicrobials by the HMC’s ASP during two time periods; premature ASP use versus mature ASP use
• Period one was defined as the 12 months immediately upon ASP implementation (May 1, 2015-April 30, 2016), and period two was defined as a recent 12 months of ASP implementation (February 1, 2019- January 31, 2020) • The study was conducted in the women’s health wards in HMC
• The targeted antimicrobial use in this study is based on that performed in cohort of patients admitted to the inpatient wards of women wards during the study follow-up durations
• Sample size was planned based on the premature ASP use within 1-year duration (i.e. May 1, 2015 to April 30, 2016) versus mature ASP use within 1-year duration (i.e. February 1, 2019 to January 31, 2020)
• The overall economic benefit of the ASP maturity was calculated as the sum of the cost savings and the cost avoidance, associated with the service, minus the operational cost of the service
• Sensitivity analyses (SA) were conducted to enhance the robustness of the study conclusion and the generalizability of study findings

Results

• The total cost saving due to reduction in DDDs and resources with ASP maturity is QAR 26,163
• The cost avoided was QAR 103,874 in favor of the mature period
• The reduction in total operational cost was QAR12,477 in favor of the mature period
• Sensitivity analyses were insensitive to majority of input uncertainties (Figures 1 and 2)
• The main contributing factor was cost of hospitalization

Conclusions

• This study demonstrates that ASP maturity may offset or reduce costs to QAR 26,163 by minimizing antimicrobials consumption and resource utilization