Blue Cross Blue Shield Association Study Shows Progress in Reducing the Number of Antibiotic Prescriptions Filled

Nine percent decline in antibiotic prescriptions filled over a seven-year period; steepest drop is among children

CHICAGO – The rate at which antibiotic prescriptions were filled declined nine percent from 2010 through 2016, according to a study by the Blue Cross Blue Shield Association (BCBSA) – evidence that public health campaigns aimed at curbing over-use of the common medicines are taking hold.

Pediatricians appear to lead the way in curtailing antibiotic use with prescriptions filled for children dropping 16 percent. The steepest decline was among infants with a drop of 22 percent.

Significantly, the data also show that Blue Cross and Blue Shield (BCBS) members filled 13 percent fewer prescriptions for broad spectrum antibiotics, the type used to treat a wide range of bacteria, and which are most likely to trigger the development of antibiotic-resistant strains.

The report, “Antibiotic Prescription Fill Rates Declining in the U.S.,” represents a comprehensive study of outpatient medical claims from commercially insured BCBS members who filled antibiotic prescriptions over a seven-year period.

The study also finds that:

  • There is wide regional variation in antibiotic use with Mississippi, Alabama and Arkansas showing the highest rates of prescriptions filled. The rate at which BCBS members filled antibiotic prescriptions in these three states was nearly three times greater than those in the lowest states of Hawaii, Oregon and Montana.
  • Those in rural areas filled prescriptions at a rate 16 percent higher than BCBS members in urban areas.
  • In 21 percent of cases, patients were prescribed antibiotics for conditions for which they are not likely to be an effective treatment. Broad-spectrum antibiotics were prescribed in 75 percent of these questionable cases.
  • Prescriptions for reserved antibiotics spiked 30 percent and are the only category of antibiotic showing an upswing in use. They are used infrequently and typically are meant as a treatment of last resort to fight bacteria that have developed resistance to other antibiotics.

“Public health efforts to increase the awareness of excessive antibiotic use and the threat posed by antibiotic-resistant bacteria appear to be achieving measurable results,” said Dr. Trent Haywood, senior vice president and chief medical officer for BCBSA. “This report demonstrates that antibiotic use among commercially insured people in the U.S. is declining, and it is largely due to the reduction in the use of broad-spectrum antibiotics—the type most likely to contribute to the creation of resistant bacteria. Unfortunately, the data also show continued high use of broad-spectrum antibiotics for conditions where they have limited effectiveness, indicating there are further improvements to be made.”

Dr. Denise Cardo, director of the Centers for Disease Control and Prevention’s Division of Healthcare Quality Promotion, says that having information on antibiotic use is a key component of efforts to improve antibiotic prescribing. “We are pleased to see improvements in prescribing for children, but we recognize that there are still opportunities to improve antibiotic use in all ages. CDC is applying what we have learned from successes in children to inform best practices for antibiotic prescribing in adults. We applaud BCBSA for making their data available to inform action.”  

This is the fifteenth study of the Blue Cross Blue Shield: The Health of America Report® series, a collaboration between BCBSA and Blue Health Intelligence, which uses a market-leading claims database to uncover key trends and insights into health care affordability and access to care. Analysis was performed by and also includes medical claims data from HealthCore, a wholly owned and independently operated subsidiary of Anthem, Inc.

For more information, visit

About HealthCore, Inc.
HealthCore, Inc is a wholly-owned and independently operated subsidiary of Anthem, Inc., with a first of a kind large, integrated database and deep understanding of the complexities and nuances of big data. HealthCore helps clients achieve evidence-based competitive advantages through our innovative problem solving, analytics and outcomes research expertise. HealthCore doesn’t sell data. Instead, we design custom data-driven research solutions and guide our clients in the optimal use and interpretation of the data by evaluating the impact of disease, treatment and medical care on outcomes. HealthCore is headquartered in Wilmington, DE with additional offices in Andover, MA and Alexandria, VA. Our team includes scientists, biostatisticians, epidemiologists, pharmacists, and physicians. We are organized into three separate divisions, based on health care sectors, with firewalled teams collaborating with clients.

About BHI
Blue Health Intelligence (BHI) is the nation’s premier resource for data-driven insights about healthcare trends and best practices, promoting healthier lives and more affordable access to safe and effective care. BHI leverages a team of analytics experts and advanced technology, coupled with access to the greatest number of healthcare claims—172 million lives—gathered over 10 years in a safe, HIPAA-compliant, secure database. The resulting conformed, reliable data set has the broadest, deepest pool of integrated medical and pharmacy claims, reflecting medical utilization in every ZIP code. Blue Health Intelligence (BHI) is an Independent Licensee of the Blue Cross Blue Shield Association. BHI is a trade name of Health Intelligence Company, LLC.

The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.