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September 11, 2018

Is Your Employee Population Affected by Antibiotic Overuse?

Artemis Health

Antibiotics have been in the news lately. Turns out, we’ve been taking them too often, for too long, and for the wrong reasons. Just recently, studies have shown as many as 6% of urinary tract infections are resistant to antibiotics and caused by a strain of bacteria that used to live almost exclusively in hospitals. Public health organizations are scrambling to educate doctors on smart antibiotic prescribing and new “superbugs” emerging that resist normal treatment protocols.

And chances are, someone you know has suffered from a drug-resistant infection. Health Affairs reports that the estimated cost of these infections has reached $2.2 billion annually. It’s a brewing crisis, not just in the United States, but globally.

Artemis Health is able to track, calculate, and visualize trends like these. We wanted to know how antibiotic use and overuse might affect one of our clients (self-insured employers, consultants, brokers, and more). So we fired up our sample data set and found out.

First, we looked at the number of members prescribed four common antibiotics: By far the most common antibiotic prescribed was amoxicillin, with over 2,000 claims for this drug alone in the analysis period (12 months). Cipro followed with 591 claims, then cephalexin and doxycycline. All of these drugs are used to treat common infections, everything from strep throat to a post-surgery infection.

Our sample data set is a population of just over 12,000 people. Doing the math, a whopping 32% of our population had prescriptions for just these 4 common antibiotics.

Next, we wanted to look at some of the dangerous infections that can result from antibiotic overuse. We focused on two of the most dangerous.

  1. Clostridium Difficile (C. Diff): This infection can develop in the intestinal tract when all the “good bacteria” in your gut is killed off by antibiotic use. It most commonly affects patients in long-term care facilities, and can spread like wildfire from patient to patient. Symptoms include diarrhea and painful inflammation, and it’s on the rise among young, healthy patients due to drug resistance. The CDC found that nearly 30,000 people died from C. Diff in 2015.
  2. Methicillin-resistant staphylococcus aureus (MRSA): MRSA infections are caused by a form of the most common bacteria found on the body, staphylococcus, which has developed a resistance to antibiotics. Like C. Diff, MRSA commonly occurs in a healthcare setting, and can be associated with invasive procedures (think surgery, needles, tubing, etc.). The good news is that, according to the CDC, infection rates and deaths due to MRSA are declining.

We used the Artemis Platform to track the number of claims for each of these antibiotic-resistant infections, plus the cost to an employer plan.

While only 8 members were treated for C. Diff, the average paid amount for these claims was nearly $100,000. It’s a very serious infection which may require hospitalization, surgery, expensive new antibiotics, and other interventions. It also frequently reoccurs, so patients feel better for a short time, then begin the treatment cycle all over again. Additionally, many C. Diff patients are in long-term care facilities, where the infection spreads quickly.

For MRSA, the numbers aren’t quite as alarming.

This is likely because MRSA is more common and easier to treat in an outpatient setting. Just 7 members in this sample population were treated, at an average cost of $19,882.

So what can benefits leaders do about antibiotic overuse and resistance? Patient education is key. It’s important that members understand the risks of using antibiotics, and that they know how to use them correctly. If your organization utilizes onsite, nearsite or virtual clinics, your clinical staff can provide guidelines and warnings to members so they use these drugs sparingly and appropriately.

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