Evidence mapPaperPMID 41758790Full record

ArticlePloS one2026

Antibiotic consumption and medication cost in diabetic patients: Insights from Iran health insurance organization (IHIO) claims data.

Arash Bagherian Ghotbi, Benyamin Khoshparast, Hamidreza Hekmat, Zahra Shahali, Ali Golestani, Ozra Tabatabaei-Malazy

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Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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6 authors.

Arash Bagherian GhotbiNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Benyamin KhoshparastNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Hamidreza HekmatSchool of Medicine, Baharloo Hospital, International Campus, Tehran University of Medical Sciences, Tehran, Iran.
Zahra ShahaliNational Center for Health Insurance Research, Tehran, Iran.
Ali GolestaniNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Ozra Tabatabaei-MalazyEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.ORCID https://orcid.org/0000-0003-0188-9721

Funding

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6 · The paper itself

Abstract

backgroundThe rising prevalence of diabetes is increasing the healthcare costs especially when associated with infection. We aimed to assess the antibiotic consumption and medication costs in diabetes.

methodsWe performed a retrospective claims-based study using Iranian Health Insurance Organization (IHIO) dataset from 24 provinces during 2014-2017. Systemic antibacterials were quantified in defined daily doses and diabetic patients were stratified into "No antibiotic" (NAb) and quartiles of cumulative antibiotic exposure (Q1-Q4). A dominant antidiabetic regimen was assigned when ≥80% of a patient's diabetes prescriptions came from one drug class or combination. Inflation-adjusted annual medication costs were modelled with log-link Gamma generalized linear models.

resultsThe study comprised 1,704,182 individuals (62.0% women). Biguanides alone were most common dominant diabetes regimen (40%), whereas penicillin accounted for 35.8% of all antibiotic dispensing. Mean annual medication costs were 93 USD for women and 138 USD for men; however, after adjustment men incurred slightly lower costs than women. Compared with the NAb group, costs rose progressively with antibiotic exposure, reaching an adjusted mean ratio (MR) 3.17 (95%CI 3.09-3.25) in Q4. Relative to biguanide monotherapy, costs were markedly higher for regimens biguanides + insulins (MR 5.75, 5.54-5.97) or insulins alone (MR 5.53, 5.38-5.68).

conclusionQuantifying the joint impact of antidiabetic regimens and antibiotic use on treatment costs highlights key factors driving healthcare expenditures. These findings can inform targeted antibiotic stewardship strategies and guide reimbursement policy to optimize resource allocation and reduce the financial burden on both patients and insurers.

Indexed as

Anti-Bacterial AgentsDiabetes MellitusDrug CostsAdultAgedFemaleHealth Care CostsHumansHypoglycemic AgentsInsurance, HealthIranMaleMiddle AgedRetrospective StudiesAnti-Bacterial AgentsHypoglycemic Agents

Identifiers

PMID41758790
PMCPMC12948126

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