Universität zu Köln

Jeck, Julia ORCID: 0000-0002-4669-690X, Wingen-Heimann, Sebastian M., Jakobs, Florian, Franz, Jennifer, Baltin, Christoph T., Kron, Anna, Boell, Boris, Kochanek, Matthias ORCID: 0000-0002-4766-4651, Cornely, Oliver A. ORCID: 0000-0001-9599-3137 and Kron, Florian (2022). Last Resort Antibiotics Costs and Reimbursement Analysis of Real-Life ICU Patients with Pneumonia Caused by Multidrug-Resistant Gram-Negative Bacteria in Germany. Healthcare, 10 (12). BASEL: MDPI. ISSN 2227-9032

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Abstract

Multidrug-resistant Gram-negative bacteria (MDR-GNB) cause serious infections and aggravate disease progression. Last resort antibiotics are effective against MDR-GNB and are reimbursed by flat rates based on German diagnosis-related groups (G-DRG). From a hospital management perspective, this analysis compared hospital reimbursement for last resort antibiotics with their acquisition costs to outline potential funding gaps. Retrospective analyses based on medical charts and real-life reimbursement data included patients with pneumonia due to MDR-GNB treated in intensive care units (ICU) of a German tertiary care hospital (University Hospital Cologne) between January 2017 and December 2020. Drug-associated hospital reimbursement of G-DRG was compared with drug acquisition costs based on preliminarily approved last resort antibiotics (cefiderocol, ceftazidime-avibactam, ceftolozane-tazobactam, and imipenem-cilastatin-relebactam) according to label. Funding gaps were determined for the treatment of Enterobacterales, Pseudomonas aeruginosa, Acinetobacter baumannii, and mixed infections, respectively. Most of the 31 patients were infected with Enterobacterales (n = 15; 48.4%) and P. aeruginosa (n = 13; 41.9%). Drug-associated G-DRG reimbursement varied from 44.50 EUR (mixed infection of P. aeruginosa and Enterobacterales) to 2265.27 EUR (P. aeruginosa; mixed infection of P. aeruginosa and Enterobacterales). Drug acquisition costs ranged from 3284.40 EUR in ceftazidime-avibactam (minimum duration) to 15,827.01 EUR for imipenem-cilastatin-relebactam (maximum duration). Underfunding was found for all MDR-GNB, reaching from 1019.13 EUR (P. aeruginosa; mixed infection of P. aeruginosa and Enterobacterales) to 14,591.24 EUR (Enterobacterales). This analysis revealed the underfunding of last resort antibiotics in German hospital treatment. Insufficient reimbursement implies less research in this field, leading to a more frequent use of inappropriate antibiotics. The cycle closes as this contributes to the development of multi-drug resistant bacteria.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Jeck, Julia UNSPECIFIED orcid.org/0000-0002-4669-690X UNSPECIFIED Wingen-Heimann, Sebastian M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jakobs, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Franz, Jennifer UNSPECIFIED UNSPECIFIED UNSPECIFIED Baltin, Christoph T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kron, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Boell, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED Kochanek, Matthias UNSPECIFIED orcid.org/0000-0002-4766-4651 UNSPECIFIED Cornely, Oliver A. UNSPECIFIED orcid.org/0000-0001-9599-3137 UNSPECIFIED Kron, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-676302
DOI:	10.3390/healthcare10122546
Journal or Publication Title:	Healthcare
Volume:	10
Number:	12
Date:	2022
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2227-9032
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Health Care Sciences & Services; Health Policy & Services Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67630