Session Type: 1-hour Oral Session
Session Title: 1-hour Oral Session
Authors(s): P. Tulkens
Authors Affiliations(s): Université catholilque de Louvain, Belgium
Background:
Unnecessary antibiotic use fosters antibiotic resistance, and public campaigns have been presented as successful in reducing it. Yet, long-term analysis of Belgian reimbursement data showed no or only negligible long-terms effects. Belgian data up to 2020 have now been analyzed and assessed for impact of (i) global price decrease (introduction of generics), (ii) increase in co-payment for all antibiotics in 2018, and (iii) restrictive conditions for quinolones ( in 2019).
Methods:Antibiotic reimbursement data (monetary terms (total expenses and patient’s co-payments) and Defined Daily Doses [DDD; WHO-recommended unit for cross-markets comparisons]) were collected from the National Institute for Insurance against Sickness and Invalidity (defining drug reimbursement conditions in Belgium). DDDs and expenses were introduced as continuous variables, and campaigns, change in drug reimbursement class, and in conditions of reimbursement as categorical variables (“before and after” and longitudinal changes). Principal component analysis was used to assess the impact of all variables on the number of DDD’s of quinolones reimbursed.
Results:Figure 1 shows that campaigns had only a transient initial effect, followed by an increase in reimbursed DDD’s (mainly β-lactams). Fluoroquinolones were kept at low but fluctuating levels throughout until 2018. Global price decreases were associated with an increase in reimbursed DDD’s (β-lactams). Co-payment increase (reimbursement class B to C; see Figure 2) was without immediate effect. Conversely, restrictive conditions for reimbursement of fluoroquinolones (moved to chapter IV; Figure 2) was associated with immediate reduction (~40 %) in reimbursed DDD’s). Statistical analyses confirmed these conclusions (not illustrated). Principal component analysis (Figure 3) identified the move of fluoroquinolone to chapter IV (see what it implies in Fig 2) as the main contributing factor to the decrease of their reimbursed DDD’s (no difference in cost of typical treatments between restricted fluoroquinolones and unrestricted antibiotics [see example]).
Conclusions:Public campaign were not associated with sustained reduction in the number of reimbursed DDD’s and globval price decrease was actually associated with minor but worrying increase. Only setting restrictive rules were associated with major reduction (quinolones). Examining only reimbursed antibiotics may be a limitation to address in the future.
Keyword(s): antibiotics, reimbursement, consumptionCOI Other: None
Session Type: 1-hour Oral Session
Session Title: 1-hour Oral Session
Authors(s): P. Tulkens
Authors Affiliations(s): Université catholilque de Louvain, Belgium
Background:
Unnecessary antibiotic use fosters antibiotic resistance, and public campaigns have been presented as successful in reducing it. Yet, long-term analysis of Belgian reimbursement data showed no or only negligible long-terms effects. Belgian data up to 2020 have now been analyzed and assessed for impact of (i) global price decrease (introduction of generics), (ii) increase in co-payment for all antibiotics in 2018, and (iii) restrictive conditions for quinolones ( in 2019).
Methods:Antibiotic reimbursement data (monetary terms (total expenses and patient’s co-payments) and Defined Daily Doses [DDD; WHO-recommended unit for cross-markets comparisons]) were collected from the National Institute for Insurance against Sickness and Invalidity (defining drug reimbursement conditions in Belgium). DDDs and expenses were introduced as continuous variables, and campaigns, change in drug reimbursement class, and in conditions of reimbursement as categorical variables (“before and after” and longitudinal changes). Principal component analysis was used to assess the impact of all variables on the number of DDD’s of quinolones reimbursed.
Results:Figure 1 shows that campaigns had only a transient initial effect, followed by an increase in reimbursed DDD’s (mainly β-lactams). Fluoroquinolones were kept at low but fluctuating levels throughout until 2018. Global price decreases were associated with an increase in reimbursed DDD’s (β-lactams). Co-payment increase (reimbursement class B to C; see Figure 2) was without immediate effect. Conversely, restrictive conditions for reimbursement of fluoroquinolones (moved to chapter IV; Figure 2) was associated with immediate reduction (~40 %) in reimbursed DDD’s). Statistical analyses confirmed these conclusions (not illustrated). Principal component analysis (Figure 3) identified the move of fluoroquinolone to chapter IV (see what it implies in Fig 2) as the main contributing factor to the decrease of their reimbursed DDD’s (no difference in cost of typical treatments between restricted fluoroquinolones and unrestricted antibiotics [see example]).
Conclusions:Public campaign were not associated with sustained reduction in the number of reimbursed DDD’s and globval price decrease was actually associated with minor but worrying increase. Only setting restrictive rules were associated with major reduction (quinolones). Examining only reimbursed antibiotics may be a limitation to address in the future.
Keyword(s): antibiotics, reimbursement, consumptionCOI Other: None