Outpatient parenteral antimicrobial therapy (OPAT) can reduce treatment costs by an average of 36% compared to inpatient therapy, according to a first-of-its-kind study.
The recently published systematic review and meta-analysis by international researchers considered 20 studies involving 2,790 patients.
The average cost of OPAT per treatment episode was $10,454 compared to $16,492 for inpatient care. In the six studies eligible for meta-analysis, including three randomised controlled trials and three cohorts, OPAT saved an average of $5,437 per care episode.
Cost savings were observed across OPAT delivery models, including clinic-based, physician- or nurse-administered, and self- or carer-administered care.
OPAT programmes were evaluated across a range of infections, such as febrile neutropenia, cystic fibrosis, osteomyelitis, endocarditis and appendicitis.
The main driver of savings was the ability to free up hospital beds, the researchers found. In addition to direct treatment cost reductions, they also discussed how OPAT may enable more efficient bed use and reduced risk of nosocomial infections.
Patient experiences of OPAT
While OPAT offers clear clinical and economic advantages, the researchers noted that some patients faced practical challenges, such as struggling with self-administering medication due to low confidence, leading to potential device-related complications.
The analysis also revealed that continuous intravenous therapy could disrupt daily life, including mobility, hygiene, sleep and school or social participation, and OPAT increased the caregiving burden in some families.
Travel requirements for monitoring or treatment also posed difficulties, particularly for those with limited transport or who lived far from healthcare facilities.
Pharmacoeconomic studies required
While OPAT was shown to significantly save costs compared to inpatient treatment, the researchers acknowledged limitations of the study, including heterogeneity of infection type, cost calculation methods and a lack of randomised controlled trial data.
They called for more comprehensive pharmacoeconomic studies comparing inpatient and OPAT, ‘from the perspectives of patients, healthcare providers, payers and the society’.
Furthermore, they advocated for comparisons between OPAT and outpatient complex oral antimicrobial regimens to provide more complete cost benefit evaluations.
Reference
Mohammed SA et al. Quantifying cost savings from outpatient parenteral antimicrobial therapy programme: a systematic review and meta-analysis. JAC Antimicrob Resist. 2025;7(2):dlaf049.
