Effects of economic and health policies on the consumption of antibiotics in a Spanish region

Abstract

ABSTRACT Objectives Inappropriate and indiscriminate use of antibiotics is one of the main factors contributing to the increasing bacterial resistance. Surveillance of antibiotic consumption is fundamental for assessing the effects of rational use-oriented measures introduced under economic or health policies. This study quantifies and assesses the introduction of a pharmaceutical co-payment and implementation of campaigns to increase awareness about and rational use in the consumption of antibiotics (volume and expenditure). Methods Monthly official dispensations recorded by a health authority (La Rioja, Spain) between January 2009 and December 2017 (108 observations). Total and disaggregated (by active principle and patient’s income level) time series for a number of packages and expenditure were studied using intervention and counterfactual analyses (Box–Jenkins methodology). Results Co-payment reduced the total antibiotic consumption (number of packages −8.52% and expenditure −8.61%) and the difference was greater for the highest-priced antibiotics. Only two of the four campaigns had a significant effect, which lasted 6 months. Counterfactual analysis estimated the savings. Conclusion Economic and health policies helped to reduce antibiotic consumption. Each policy has different effects, co-payment reduces overall drug consumption through a price effect (loss of purchasing power), awareness campaigns depend on other elements for their success (media, scope and patient income).