Journal Article

Medicare Coverage of Outpatient Ambulatory Intravenous Antibiotic Therapy: A Program that Pays for Itself

Alan D. Tice, Donald Poretz, Francesca Cook, Darren Zinner and Michael J. Strauss

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 6, pages 1415-1421
Published in print December 1998 | ISSN: 1058-4838
Published online December 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515028
Medicare Coverage of Outpatient Ambulatory Intravenous Antibiotic Therapy: A Program that Pays for Itself

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A number of studies have documented the safety, efficacy, and cost-effectiveness of outpatient intravenous (iv) antibiotic therapy for patients with infectious diseases. Nevertheless, Medicare policy prohibiting coverage of outpatient, self-administered drugs has severely limited access of Medicare patients to ambulatory iv therapy, thus forcing them to rely on more costly, inpatient hospital care. To test the hypothesis that a new Medicare benefit providing coverage for ambulatory iv antibiotic therapy could significantly reduce the program's expenditures for the treatment of infectious diseases (including pneumonia, osteomyelitis, cellulitis, and endocarditis), a cost model was constructed with use of patient care information from the clinical literature as well as clinical experts, Medicare data, and other medical claims databases. The model shows cumulative 5-year savings of nearly $1.5 billion associated with the new Medicare benefit. Policy makers should consider implementing such a benefit.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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