2201. Cost of Antimicrobial Use Against Upper Respiratory Infection in Japan

Abstract

Abstract Background Antibiotics are often inappropriately prescribed for treating upper respiratory infection (URI) patients in ambulatory care settings. In Japan, a previous study estimated physicians prescribed antibiotics in about 30% of URI cases. However, trends of prescription behavior and additional costs of inappropriate antibiotic use in URI cases are still not clear in Japan. The present study’s main objective was to clarify the amount of additional cost owing to inappropriate antibiotic prescription for URI, and the recent trend. Methods We conducted a retrospective observational survey using longitudinal claims data spanning 2013–2016, obtained from the Japan Medical Data Center Co., Ltd. (JMDC) Claims Database, which contains anonymous claim data on 5.1 million (for 2013–2016) corporate employees covered by the employees’ health insurance plan (Social insurance), and their family members <65 years old. Six physicians specialized in infectious disease assessed the appropriateness of antibiotic prescription based on the ICD-10 code in the database. The total additional cost of antibiotic prescription for URI at the national level was estimated by weighting corresponds to the age-structured population data, from the healthcare payer perspective. Costs of treatment for adverse events and of antimicrobial resistance caused by inappropriate antibiotic prescription were not taken into consideration. Results The total annual cost of antibiotic prescription for URI was estimated at US$423.6 (95% confidence interval: 416.8–430.5) million in 2013, $340.9 (335.7–346.2) million in 2014, $349.9 (344.5–355.3) million in 2015, and $297.1 (292.4–301.9) million in 2016. Conclusion Although a decreasing trend was observed, the annual cost of antibiotic prescription for URI potentially imposes a substantial economic burden in Japan. Disclosures All authors: No reported disclosures.