Annual economic burden of cUTIs surpasses $6 billion in US
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Annually in the United States, there are almost 3 million cases of complicated UTIs, or cUTIs, amounting to more $6 billion in annualized 30-day costs, according to findings from a retrospective longitudinal study published in Open Forum Infectious Diseases.
“The projected economic burden associated with cUTIs on the U.S. health care system is substantial,” Thomas P. Lodise, PharmD, PhD, a professor at the Albany College of Pharmacy and Health Sciences, told Infectious Disease News.
Lodise noted that hospital reimbursement and antimicrobial stewardship programs are “increasingly tied to quality and efficiency of care.”
“These findings highlight the need for new treatment approaches and antibiotics for cUTIs that reduce hospitalization rates, facilitate early discharge, avoid readmissions and ED visits, and reduce treatment failure rates,” he said.
According to Lodise and colleagues, the incidence and health care burden associated with cUTIs has been largely overlooked and understudied despite how common they are. For their study, they retrospectively searched the PharMetrics Plus database for studies published from Jan. 1, 2013, to Dec. 31, 2017, that involved patients aged 18 years or older with a cUTI diagnosis and continuous enrollment 6 or more months before the index dates and 30 or more days after the index date. The study population was split into two cohorts depending on whether the cUTI was diagnosed in the inpatient or outpatient setting.
The study included 543,502 adult patients with cUTIs, of which 104,866 were in the inpatient cohort and 438,636 were in the outpatient cohort. The overall cUTI incidence is 1.01%, or about 2,882,195 cUTI cases in the U.S., annually. The overall median 30-day health care costs in the inpatient cohort was $13,028 compared with $1,531 for the outpatient cohort.
“The total median 30-day health care costs associated with each cUTI case was approximately $2,000 US dollars, resulting in the annualized total U.S. costs in excess of $6 billion,” Lodise said. “Although a variety of sources contributed to overall 30-day health care costs, inpatient admissions were the most substantial component.”
For the inpatient cohort, the median costs for the initial admission were $9,441, Lodise and colleagues reported. The median length of stay was 4 days and 12.3% of the inpatient cohort had a subsequent readmission. Among the outpatient cohort, 9.2% had a 30-day admission, according to the study.
“These findings have important implications for clinical practice. Clinicians need to be aware of the persistent or recurrent nature of cUTIs when developing individualized patient care plans,” Lodise said. “The results of this study also highlight the potential issues with currently available outpatient therapies as a fair number of the patients treated in the outpatient setting received multiple courses of antibiotics, subsequently visited the ED and/or were admitted to the hospital.” – by Marley Ghizzone
Disclosures: Lodise reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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