Related Experiment Video
Updated: Jan 15, 2026
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Cost-effectiveness of antimicrobial stewardship programs in Indian tertiary care hospitals: A Markov model analysis
Yuvaraj Krishnamoorthy1, Salin K Eliyas2, Monica Karunakaran3
1Evidence Synthesis Unit, Partnerships for Research, Opportunities, Planning, Upskilling and Leadership (PROPUL) Evidence, Chennai, 600099, India.
Background:
Antimicrobial resistance (AMR) poses grave threat to global health, with India particularly affected by high infectious disease burdens and rampant antibiotic misuse. Antimicrobial Stewardship Programs (ASPs) offer structured, multidisciplinary approach to optimize antibiotic use and mitigate AMR. This study aims to model the cost-effectiveness of implementing an ASP in tertiary care facilities in India.
Methods:
We performed cost-effectiveness analysis from health system perspective using Markov model comparing ASP and non-ASP scenarios in tertiary care hospitals in India. The model simulated 1000 hospitalized patients over daily cycles, with transitions between health states (e.g., development of sensitive or resistant infections, ICU admission, recovery, and death) informed by published literature, local hospital data, and expert opinion. Key outcomes included hospital and ICU days saved, deaths and DALYs averted, and incremental cost-effectiveness ratios (ICERs) for DALYs averted. Sensitivity analyses were conducted using Monte Carlo simulations to test the robustness of our findings.
Results:
The ASP scenario achieved total care cost of ₹6.29 million ($74998.06), compared to ₹22.07.09 million ($267263.34485,458.99) in non-ASP setting - 72.0 % cost reduction. ASPs reduced ward, ICU, and overall hospital stay by 677, 187, and 865 days, respectively, and averted 4.9 deaths (5.3 % reduction). All ICURs were negative, demonstrating that ASPs are both cost-saving and more effective.
Conclusions:
Implementation of ASPs in Indian tertiary care facilities is economically advantageous and clinically beneficial. By reducing healthcare costs, resource utilization, and mortality, ASPs represent a sustainable strategy to mitigate AMR in resource-limited settings.
Insights
Implementing Antimicrobial Stewardship Programs (ASPs) in Indian hospitals significantly reduces costs and improves patient outcomes. These programs are a cost-saving strategy to combat antimicrobial resistance (AMR).
Area of Science:
- Health Economics
- Infectious Disease Management
- Public Health Policy
Background:
- Antimicrobial resistance (AMR) is a critical global health threat, exacerbated in India by high disease burdens and antibiotic misuse.
- Antimicrobial Stewardship Programs (ASPs) are essential for optimizing antibiotic use and combating AMR.
Purpose of the Study:
- To model the cost-effectiveness of implementing ASPs in tertiary care facilities in India.
- To evaluate the economic and clinical benefits of ASPs in a resource-limited setting.
Main Methods:
- A Markov model was used for cost-effectiveness analysis from a health system perspective.
- The model simulated 1000 hospitalized patients, comparing ASP and non-ASP scenarios.
- Data from literature, local hospitals, and expert opinion informed transitions between health states; sensitivity analyses were performed.
Main Results:
- The ASP scenario resulted in a 72.0% cost reduction compared to the non-ASP setting.
- ASPs reduced hospital and ICU stays, averting 4.9 deaths and demonstrating negative incremental cost-effectiveness ratios (ICERs).
- The study found ASPs to be both cost-saving and more effective.
Conclusions:
- Implementing ASPs in Indian tertiary care facilities is economically advantageous and clinically beneficial.
- ASPs reduce healthcare costs, resource utilization, and mortality.
- ASPs offer a sustainable strategy for mitigating AMR in resource-limited settings.
More Related Videos
09:59Application of the Intelligent High-Throughput Antimicrobial Sensitivity Testing/Phage Screening System and Lar Index of Antimicrobial Resistance
Published on: July 21, 2023
09:26Antibiotic Efficacy Testing in an Ex vivo Model of Pseudomonas aeruginosa and Staphylococcus aureus Biofilms in the Cystic Fibrosis Lung
Published on: January 22, 2021
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:28Antimicrobial Effectiveness
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:18Endocarditis III: Medical Management
01:22Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence