The cost of antibiotic prescriptions in children in the Lombardy Region: A reduction is possible

▶ Aims. To elaborate a cost analysis of the expenditure for antibiotic prescriptions in outpatient children in the Lombardy Region and for each of the region's LHUs. To estimate the cost impact associated with a quali-quantitative improvement in antibiotic prescribing. ▶ Methods. The data source was the Lombardy Region's prescription database (year 2008) for outpatient children <14 years old. The analysis concerned the 10 most prescribed antibiotics, representing 97% of all antibiotic prescriptions. The average total expenditure for each package, and per capita, was calculated for each active substance considered and for each LHU. An estimate of the possible cost reduction was elaborated by using the improved prescription profile of a group of paediatricians who has been involved in initiatives evaluating appropriateness of care for years as a reference. ▶ Results. The per-capita expenditure for the 10 most prescribed antibiotics varies from 10,39 € in Milan to 17,05 € in Lodi. The cost reduction estimate reveals a possible reduction in expenditure of about 3,5 million euros (∼19,1%) in the Lombardy Region. The LHU that does not show a possible reduction is Milan (about 160 thousand euros more), while the LHU with the greatest potential to reduce costs is Brescia (about 900 thousand euros saved). ▶ Conclusions. This study showed that by improving prescribing appropriateness it is possible to reduce the expenditure associated with outpatient children antibiotic prescriptions in the Lombardy Region by about one fifth.