Comparing The Cost Of Antibiotics for Children

In 2009, antibiotics covered by private insurance companies in the U.S. for children were estimated to be more than five times higher than in the United Kingdom.

We all know that the healthcare system in the U.S. has some serious issues, and that the implementation of the Affordable Care Act (ACA) has led to renewed attention and debate on U.S. health care costs. And that the price of prescription drugs continues to be a major burden for many people. But what about when it comes to the cost of antibiotics for children?

In the United Kingdom, where antibiotics for children under 10-years-old are covered by a government universal health plan, the costs of prescription drugs were estimated to be five times less than here in the U.S. Five times. This number comes from Boston University’s Boston Collaborative Drug Surveillance Program which is conducting a comparison of prescription drug costs between the U.S. and U.K. The study appears online in the journal Pharmacotherapy.

According to the study:

The researchers identified 160,000 children younger than 10-years-old who were prescribed at least one or more drugs in 2009 in both the U.S. and the U.K. Rates of prescribed antibiotics—75 percent of children in the U.S. compared to 50 percent in the U.K., were calculated by dividing the number of children who received at least one prescription for an oral antibiotic by the total number of children in each database in 2009. Similarly, they estimated the rate of use of each antibiotic separately. 

In the U.S., the cost of each prescription was ascertained directly from a random sample of users derived from the original electronic records. In the U.K., the duration and cost of each prescription was derived from the electronic medical record and based on the 2009 Prescription Cost Analysis reported by the National Health Service and converted to dollars. Total annual cost for each antibiotic was estimated by multiplying the dollar cost per prescription by the number dispensed.

According to the study’s authors, in order to make a reliable comparison of relative costs between countries, researchers used large, continuous, and standardized recording systems of data that accounted for age, gender, calendar time, geography, and other necessary variables.

“Unlike the variability in factors related to the cost of medical procedures and hospitalizations, prescription drugs have the unique advantage in that they are typically produced by a single or relatively few international pharmaceutical companies. Furthermore, a particular drug has the same chemical structure wherever it is produced,” says the study’s lead author Dr. Hershel Jick, director emeritus of the Collaborative Drug Surveillance Program and associate professor of medicine at Boston University School of Medicine.

Jick says that information on a majority of drugs, including those prescribed primarily for children, can be derived from continuous reliable electronic data resources such as the ones that were utilized in this particular study. “[These factors] yield critical insight into the difference in drug costs between the U.S. private sector compared to the U.K. government that can lead to creation of policy that provides greater efficiency and large cost savings,” Jick says.

The impact of the ACA on private insurance prescription drug use and cost through enrollment in health care insurance exchanges can be followed in real time at little expense using existing reliable electronic resources. But Jick says that since more insurers are now participating, costs could now be reduced as a result of increased market competition.

Although all of the antibiotics were available in generic formulation in both countries, the percentage of children prescribed an antibiotic was far higher in the U.S. The particular antibiotics commonly prescribed in the U.S. were regularly more costly and prescribed for longer durations. This is not surprising, since a recent Brigham and Women’s Hospital study found that antibiotics are overprescribed in the U.S.

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