Cost savings of outpatient parenteral antimicrobial therapy using a digital infusion pump

Outpatient parenteral antimicrobial therapy (OPAT) enables IV antibiotic administration outside hospital settings and has been found to reduce costs and improve patient satisfaction. In Norway, OPAT has been less established due to the preference for narrow-spectrum antibiotics often requiring multiple daily doses. We undertook a cost evaluation of an OPAT programme using a continuous ambulatory delivery device (CADD), and comparison with costs of inpatient treatment for equivalent IV antibiotic courses.

A retrospective cost analysis was conducted on 170 consecutive patients treated with OPAT at Sørlandet Hospital, Norway (2016-2021). Eligible patients received multidose IV antibiotics at home using CADD pumps. OPAT costs included equipment and antibiotics, staff time, transportation and patient time, and were compared with estimated inpatient costs for the same treatment and duration. Sensitivity analyses tested robustness of the findings across various cost scenarios.

A total of 170 patients received OPAT, mostly with narrow-spectrum β-lactam antibiotics, with a mean duration of 16.4 days per patient (range 1-67 days), and an estimated saving of approximately 51 hospital bed days per month. The mean cost per OPAT treatment was €1603 versus €12 982 for inpatient care, i.e. representing 12% of inpatient costs. Sensitivity analysis confirmed OPAT savings between 72% and 89% across scenarios.

These findings confirm that a CADD-based OPAT programme considerably reduces costs on a societal perspective in a publicly funded health system and contributes to reduced hospital bed occupancy. The ability to administer narrow-spectrum antibiotics supports antimicrobial stewardship.