Clinical efficacy and cost-effectiveness of outpatient parenteral antibiotic therapy (OPAT): a UK perspective

Objectives: Outpatient parenteral antibiotic therapy (OPAT) is an effective treatment strategy for a wide variety of infections as long as clinical risk is minimized by conforming to practice guidelines. However, its cost-effectiveness has not been established in the setting of the UK National Health Service. We examined the clinical efficacy and cost-effectiveness of an OPAT service based in a large UK teaching hospital, predominantly using the outpatient ‘infusion centre ’ and patient/carer adminis-tration models of service delivery. Patients and methods: Data on clinical activity and outcomes were collected prospectively on 334 epi-sodes of treatment administered by the Sheffield OPAT service between January 2006 and January 2008. Cost-effectiveness was calculated by comparing real costs of OPAT with estimated inpatient costs for these patient episodes incorporating two additional sensitivity analyses. Results: Of the OPAT episodes, 87 % resulted in cure or improvement on completion of intravenous therapy. The readmission rate was 6.3%, and patient satisfaction was high. OPAT cost 41 % of equival-ent inpatient costs for an Infectious Diseases Unit, 47 % of equivalent inpatient costs using national average costs and 61 % of inpatient costs using minimum inpatient costs for each diagnosis. Conclusions: Using this service model, OPAT is safe and clinically effective, with low rates of complications/readmissions and high levels of patient satisfaction. OPAT is cost-effective when com-pared with equivalent inpatient care in the UK healthcare setting