The Cost of Resource Use Relative to the Development of the Antimicrobial Stewardship Program in a Tertiary Cancer...

Background: Infection is a typical consequence of cancer treatment due to its immunosuppressive nature, where the high use of antimicrobials raises the risk of antimicrobial resistance (AMR). The primary objective of an antimicrobial stewardship program (ASP) is to optimize antimicrobial use, reduce the emergence of AMR, and ensure cost containment. This study sought to assess the difference in cost of resource use with the ASP in the specialized hematology/oncology setting in Qatar, before and after ASP maturity. Methods: From the perspective of the public healthcare hospital, the research investigated the difference in the cost of resource use between the developed ASP and the preliminary ASP at the National Center for Cancer Care and Research (NCCCR), Qatar. The preliminary ASP was defined as the 12 months following the establishment of the ASP (i.e., May 2015 to April 2016), while the developed ASP was defined as the last 12 months of a 5-year ASP implementation (i.e., February 2019 to January 2020). Patient records were retrospectively reviewed. The overall difference in cost of resource use was based on cost savings, cost avoidance, and operational cost measures. Results: A total of 186 patients were included in the study, with 81 in the preliminary ASP and 105 in the developed ASP. While total resource utilization costs rose by 17% in the developed ASP, per-patient analysis revealed lower resource costs of Qatari Riyal (QAR) 1390 (USD 381) compared to QAR 1546 (USD 423) in the preliminary period. The developed ASP achieved reductions in antimicrobial consumption (-55.9%) and costs (-80.9%), along with a total cost avoidance of QAR 11,969,651 (USD 3,288,366). Overall, the program resulted in a net annual reduction of QAR 13,205,840 (USD 3,618,038), which equates to QAR 180,910 (USD 49,564) saved per patient. Conclusions: At the NCCCR, Qatar, it seems that running the ASP for five years, with presumed development in its practices, was associated with reductions in antimicrobial costs, operational expenses, and overall resource spending.