Estimating cost savings from reducing antibiotic overprescription in european general practices

Background: Antibiotic (ATB) overprescription leads to antimicrobial resistance (AMR) and adverse events (AEs) and poses significant economic burdens on European healthcare systems. The aim of this study was to assess the economic impact associated with interventions aimed at reducing unnecessary ATB prescriptions in general practice, and to extrapolate the results at the European Union (EU) level. Methods: We used data from the “HAPPY PATIENT” project, a before-and-after study that implemented a multifaceted intervention in primary care settings in France, Greece, Lithuania, Poland, and Spain. Based on the outcomes observed in general practice across these five countries we extrapolated the results to estimate for each of the 27 EU member states: i) the costs of implementing the interventions, ii) the number of potentially unnecessary ATB prescriptions avoided, and iii) the potential savings due to reductions in unnecessary ATB prescriptions. We considered a realistic and an optimistic scenario: using the mean and the largest reduction in unnecessary ATB prescriptions observed across each of the five participating countries, respectively. Results: Across the EU, €2.7 billion are estimated to be spent annually on healthcare resources linked to potentially unnecessary ATB prescribed in general practice. Implementing the interventions across the EU is projected to cost €107 million. Positive net savings were estimated in both scenarios, €151 million in the realistic scenario and €423 million in the optimistic scenario. Several sensitivity analyses were conducted to characterise the substantial uncertainty surrounding these estimates, which yielded considerable potential savings in all cases.