It’s between fifteen to twenty one cents of every dollar spent by hospitals. A recent study examined the costs of antibiotic resistant infections in hospitals. The main finding (italics mine):
The total attributable hospital and societal cost ranges for ARI in the expanded sample were as follows: hospital, $3.4-$5.4 million; mortality, $7.0-$9.2 million; lost productivity, $162,624-$322,707; and total, $10.7-$15.0 million. The total medical cost, if distributed to all sample patients, added $2512-$3929 (16.8%-26.3%) to the mean unadjusted hospital cost for all sample patients.
(An aside: The last sentence describes the additional cost, not the percentage of hospital bills)
What’s even more disturbing is that for every additional–that is, unnecessary–dollar spent in the hospital, we spend two dollars as a society on things; this was calculated by calculating the loss of productivity due to deaths and due to additional days in the hospital (this is probably an underestimate).
One thing to make clear: in this study, the cost of antibiotic resistance does not include hospital-acquired infections. These were excluded (and are more expensive to treat according to the study). This study only examines the cost of an ‘ordinary’ infection that happens to be resistant.
Some other fun facts:
•the economic cost of an antibiotic resistant infection per case was between $18,588-$21,208 (patients without a resistant infection averaged ~$13,000 to put this in perspective)
•the mortality rate for patients with resistant infections was double that of patients without resistant infections (after confounding variables were removed)
•MRSA infections add an average of $10,732 to a hospital bill (after confounding effects are controlled)
•VRE (vancomycin resistant enterococci) add an average of $24,080 to a hospital bill (after confounding effects are controlled)
•Floroquinolone-resistant E. coli and Klebsiella (including ciprofloxacin–“Cipro”–resistant) add an average of $2,679 to a hospital bill (after confounding effects are controlled). They’re cheap!
•Amikacin or imipenem resistant infections add an average of $40,003 to a hospital bill (after confounding effects are controlled)
•And the mother of all infections–that is, having more than one resistant infection–adds an average of $108,413 to a hospital bill (after confounding effects are controlled)
There are a bunch of caveats: this was one hospital in one year. On the other hand, the societal costs are probably underestimated. Nonetheless, this is a huge burden. Five to ten amikacin or imipenem resistant infections can pretty much wipe out the budget for any number of preventative health problems, such as prenatal care outreach, nutritional consulting, and neonatal care programs.
While the deaths caused by antibiotic resistant infection are the greatest tragedy, the economic burden is also a silent killer.
Cited article: Rebecca R. Roberts, Bala Hota, Ibrar Ahmad, R. Douglas Scott II, Susan D. Foster, Fauzia Abbasi, Shari Schabowski, Linda M. Kampe, Ginevra G. Ciavarella, Mark Supino, Jeremy Naples, Ralph Cordell, Stuart B. Levy, and Robert A. Weinstein. 2009. Hospital and Societal Costs of Antimicrobial‐Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship. Clinical Infectious Diseases 49: 1175-1184.