A potential cost savings analysis of a penicillin de-labeling program
IntroductionOver 95% of patients documented as penicillin allergic can tolerate a penicillin without a reaction. Inaccurate documentation of penicillin allergy leads to more expensive alternative antibiotic prescriptions and an increased incidence of resistant infections.ObjectiveTo understand the p...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Allergy |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/falgy.2023.1101321/full |
| _version_ | 1797856205232668672 |
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| author | Yilu Dong Tracy N. Zembles Mark Nimmer David C. Brousseau David Vyles |
| author_facet | Yilu Dong Tracy N. Zembles Mark Nimmer David C. Brousseau David Vyles |
| author_sort | Yilu Dong |
| collection | DOAJ |
| description | IntroductionOver 95% of patients documented as penicillin allergic can tolerate a penicillin without a reaction. Inaccurate documentation of penicillin allergy leads to more expensive alternative antibiotic prescriptions and an increased incidence of resistant infections.ObjectiveTo understand the potential drug cost savings of a penicillin de-labeling program to a healthcare system.MethodsWe evaluated patient visits with documented penicillin allergy who presented to the pediatric Emergency Department (PED) and 22 associated primary care clinics. Patients were included if they were discharged home with a non-penicillin antibiotic when the first-line treatment for the diagnosis would have been a penicillin. The potential cost savings were the sum of all visit-level cost differences between the non-penicillin prescription(s) and a counterfactual penicillin prescription. To factor in a 95% successful patient de-labeling rate, we repeatedly sampled 95% from the patients with the eligible visits 10,000 times to produce an estimate of the potential cost savings.ResultsOver the 8-year period, 2,034 visits by 1,537 patients to the PED and 12,349 visits by 6,073 patients to primary care clinics satisfied eligibility criteria. If 95% of the patients could have been successfully de-labeled, it would have generated a cost saving of $618,653 (95% CI $618,617—$618,689) for all the corresponding payers in the system.ConclusionsImplementing a penicillin de-labeling program across a healthcare system PED and its associated primary care clinics would bring significant cost savings. Healthcare systems should rigorously evaluate optimal methods to de-label patients with reported penicillin allergy. |
| first_indexed | 2024-04-09T20:36:40Z |
| format | Article |
| id | doaj.art-4d343402b0dd4421a530f60fe6fbf1aa |
| institution | Directory Open Access Journal |
| issn | 2673-6101 |
| language | English |
| last_indexed | 2024-04-09T20:36:40Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Allergy |
| spelling | doaj.art-4d343402b0dd4421a530f60fe6fbf1aa2023-03-30T08:02:49ZengFrontiers Media S.A.Frontiers in Allergy2673-61012023-03-01410.3389/falgy.2023.11013211101321A potential cost savings analysis of a penicillin de-labeling programYilu Dong0Tracy N. Zembles1Mark Nimmer2David C. Brousseau3David Vyles4Pediatric Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, United StatesDepartment of Enterprise Safety, Children's Wisconsin, Milwaukee, WI, United StatesPediatric Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, United StatesPediatric Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, United StatesPediatric Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, United StatesIntroductionOver 95% of patients documented as penicillin allergic can tolerate a penicillin without a reaction. Inaccurate documentation of penicillin allergy leads to more expensive alternative antibiotic prescriptions and an increased incidence of resistant infections.ObjectiveTo understand the potential drug cost savings of a penicillin de-labeling program to a healthcare system.MethodsWe evaluated patient visits with documented penicillin allergy who presented to the pediatric Emergency Department (PED) and 22 associated primary care clinics. Patients were included if they were discharged home with a non-penicillin antibiotic when the first-line treatment for the diagnosis would have been a penicillin. The potential cost savings were the sum of all visit-level cost differences between the non-penicillin prescription(s) and a counterfactual penicillin prescription. To factor in a 95% successful patient de-labeling rate, we repeatedly sampled 95% from the patients with the eligible visits 10,000 times to produce an estimate of the potential cost savings.ResultsOver the 8-year period, 2,034 visits by 1,537 patients to the PED and 12,349 visits by 6,073 patients to primary care clinics satisfied eligibility criteria. If 95% of the patients could have been successfully de-labeled, it would have generated a cost saving of $618,653 (95% CI $618,617—$618,689) for all the corresponding payers in the system.ConclusionsImplementing a penicillin de-labeling program across a healthcare system PED and its associated primary care clinics would bring significant cost savings. Healthcare systems should rigorously evaluate optimal methods to de-label patients with reported penicillin allergy.https://www.frontiersin.org/articles/10.3389/falgy.2023.1101321/fullallergypenicillin allergyallergy de-labelingcost savingsdrug prescriptions |
| spellingShingle | Yilu Dong Tracy N. Zembles Mark Nimmer David C. Brousseau David Vyles A potential cost savings analysis of a penicillin de-labeling program Frontiers in Allergy allergy penicillin allergy allergy de-labeling cost savings drug prescriptions |
| title | A potential cost savings analysis of a penicillin de-labeling program |
| title_full | A potential cost savings analysis of a penicillin de-labeling program |
| title_fullStr | A potential cost savings analysis of a penicillin de-labeling program |
| title_full_unstemmed | A potential cost savings analysis of a penicillin de-labeling program |
| title_short | A potential cost savings analysis of a penicillin de-labeling program |
| title_sort | potential cost savings analysis of a penicillin de labeling program |
| topic | allergy penicillin allergy allergy de-labeling cost savings drug prescriptions |
| url | https://www.frontiersin.org/articles/10.3389/falgy.2023.1101321/full |
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