ANTIMICROBIAL STEWARDSHIP POLICY IMPLEMENTATION DURING COVID-19 PANDEMIC: A NATIONWIDE SERIAL CROSS-SECTIONAL STUDY
Author(s)
Yuexiang Ji, BSc, MSc candidate1, Takehiro Ishida, DrPH2, Satoshi Yamaguchi, MSc1, Ayaka Mukuta, BA candidate1, Amy Crawley, BA candidate1, Shu Sasaki, BSN candidate1, Suzuho Matsuda, BA candidate1, SHIORI TOSHIMITSU, BA1, Tomoya Ookado, MBA1, Yui Higa, BA candidate1.
1Glocal Innovator & Future Talent Society, Tokyo, Japan, 2Teikyo University Graduate School of Public Health, Tokyo, Japan.
1Glocal Innovator & Future Talent Society, Tokyo, Japan, 2Teikyo University Graduate School of Public Health, Tokyo, Japan.
OBJECTIVES: The inappropriate use of antimicrobial drugs (AMD) contributes to antimicrobial resistance (AMR) and increased healthcare expenditures. In April 2020, Japan implemented 1,000 JPY (6.3 USD) incentives and guidelines to promote appropriate AMD use, coinciding with the declaration of a COVID-19 state of emergency. This study aimed to investigate the effectiveness of the 2020 antimicrobial drug management policy revision and the impact of the COVID-19 pandemic on antimicrobial usage in Japan.
METHODS: This study conducted a nationwide serial cross-sectional study using NDB Open Data, publicly-available aggregated national reimbursement claims database published by the Ministry of Health, Labour and Welfare.Trends in antimicrobial use from FY2016 (April 2016-March 2017) to FY2022 (April 2022-March 2023) were analyzed using DDD(Defined Daily Dose) per 1,000 inhabitants per day (DID) from antibiotic prescription data. The mean (95% CI) for DID was calculated across the 47 prefectures. A two-sided p < 0.05 was considered significant. Based on the defined unit price for approved medicines by MHLW, this study calculated expenditure for antimicrobial drugs.
RESULTS: Overall DID decreased from 15.69 to 11.61 between FY2016 and FY2022, representing a 26.0% reduction, and the largest reduction was observed in FY2019-2020. The DID value decreased from 14.41 in FY2019 to 11.21 in FY2020, representing a 22.21% reduction. The mean (95% CI) of DID across the 47 prefectures was 14.36 (13.96-14.75) in FY2019 and 11.33 (11.01-11.65) in FY2020. The FY2019-2020 reduction ratio was 3.02 (2.89-3.16) and this reduction was statistically significant (p<0.001).Total expenditure for antimicrobial drugs decreased from approximately USD 0.98 billion in FY2016 to USD 0.46 billion in FY2022, representing a 53.1% reduction.
CONCLUSIONS: The results suggest statistically significant reduction of antimicrobial use after policy implementation during the COVID-19 pandemic. The considerable decline in expenditure for antimicrobial drugs might reflect the concurrent promotion of generic drug substitution in Japan.
METHODS: This study conducted a nationwide serial cross-sectional study using NDB Open Data, publicly-available aggregated national reimbursement claims database published by the Ministry of Health, Labour and Welfare.Trends in antimicrobial use from FY2016 (April 2016-March 2017) to FY2022 (April 2022-March 2023) were analyzed using DDD(Defined Daily Dose) per 1,000 inhabitants per day (DID) from antibiotic prescription data. The mean (95% CI) for DID was calculated across the 47 prefectures. A two-sided p < 0.05 was considered significant. Based on the defined unit price for approved medicines by MHLW, this study calculated expenditure for antimicrobial drugs.
RESULTS: Overall DID decreased from 15.69 to 11.61 between FY2016 and FY2022, representing a 26.0% reduction, and the largest reduction was observed in FY2019-2020. The DID value decreased from 14.41 in FY2019 to 11.21 in FY2020, representing a 22.21% reduction. The mean (95% CI) of DID across the 47 prefectures was 14.36 (13.96-14.75) in FY2019 and 11.33 (11.01-11.65) in FY2020. The FY2019-2020 reduction ratio was 3.02 (2.89-3.16) and this reduction was statistically significant (p<0.001).Total expenditure for antimicrobial drugs decreased from approximately USD 0.98 billion in FY2016 to USD 0.46 billion in FY2022, representing a 53.1% reduction.
CONCLUSIONS: The results suggest statistically significant reduction of antimicrobial use after policy implementation during the COVID-19 pandemic. The considerable decline in expenditure for antimicrobial drugs might reflect the concurrent promotion of generic drug substitution in Japan.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
HSD23
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas