Antibiotic Prescription Fill Rates Declining in the U.S.

The overuse of antibiotics, which is known to cause antibiotic-resistant bacteria, has been a topic of concern among health care professionals and policy makers in America for many years.1 In particular, the use of broad-spectrum antibiotics to treat a wide range of bacteria has been found to create antibiotic-resistant strains of bacteria. These resistant bacteria are immune to common medications and are difficult to treat.2

Since 2010, antibiotic prescription rates in the U.S. have been declining among the commercially insured population, falling 9% during this period. This decline indicates that considerable progress is being made in public health campaigns to limit the use of antibiotics and prevent the development of antibiotic-resistant bacteria.

In this report, the Blue Cross Blue Shield Association, in partnership with HealthCore and Blue Health Intelligence, examines antibiotic prescriptions filled by commercially insured members from 2010 to 2016 as a result of an outpatient visit. Antibiotics administered as part of an inpatient visit were not included in this study. The scope of the research included 173 million patient claims for filled antibiotic prescriptions from over 31 million commercially insured Americans under age 65. This report includes antibiotics that were prescribed to and filled by a patient (referred to here as the antibiotic prescription fill rate) and are thereby considered as antibiotics used to treat a patient’s condition.

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Key Findings

01

The fill rate of outpatient antibiotic prescriptions declined 9% among commercially insured Americans from 2010 to 2016.

Key Findings

02

Broad-spectrum antibiotic fill rates dropped the most at 13%. Broad-spectrum antibiotics are the type most likely to facilitate the creation of antibiotic-resistant bacteria.

Key Findings

03

The drop-in antibiotic fill rates was significantly greater in children (16%) when compared to adults (6%), with infants experiencing the steepest decline (22%).

Key Findings

04

Wide regional variation in antibiotic prescription fill rates exists, with the highest-prescribing states filling nearly three times as many prescriptions per person as the lowest-prescribing states.

Key Findings

05

While progress has been made, further improvements surrounding antibiotic prescriptions are warranted. In 2016, healthcare professionals prescribed antibiotics in more than 20 percent of outpatient visits where their use is not indicated to treat the condition.3

ENDNOTES

  1. Several professional societies and governing bodies have started and supported antibiotic stewardship programs to promote judicious use of antibiotics. Central to those efforts is the CDC’s Get Smart campaign. Other more recent national campaigns include the Choosing Wisely campaign by the American Board of Internal Medicine Foundation (2012) and the White House’s National Action Plan to Combat Antibiotic-Resistant Bacteria (2015).
  2. The Centers for Disease Control and Prevention (CDC) analyzed outpatient antibiotic prescriptions in 2010 and 2011, around the starting time frame for the data trend in this report, and found that approximately 30 percent of the prescriptions were unnecessary. For more information, see: https://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html.
  3. “Not indicated” conditions are common, non-bacterial diagnoses that are generally considered to be inappropriate for antibiotic use and are the focus of antibiotic stewardship programs.

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