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Telemedicine does not lead to increased or lower-quality antibiotic prescribing by general practitioners (GPs), Monash University research involving the University of Melbourne and University of Technology Sydney (UTS) has found.
Published in the Journal of Health Economics, the study was prompted by the rapid expansion of telemedicine via phone or video conference during the COVID-19 pandemic.
It evaluated the effect of telemedicine on antibiotic prescribing in Australian primary care, using Medicare administrative data.
Researchers investigated whether telemedicine might compromise antibiotics prescribing quality, given concerns about overprescribing generally and the fact that inappropriate use fuels antimicrobial resistance.
Using anonymised administrative GP and patient data, researchers compared prescribing patterns before and after subsidised telemedicine was introduced in 2020. Doctors were classified according to how intensively they used remote consultations once available.
GPs who adopted telemedicine more intensively reduced their antibiotic use relative to those who relied less on remote consultations. On average, high telemedicine adopters prescribed around 5 per cent fewer antibiotics per 100 consultations than those who used it less.
Low-value antibiotic use, such as the share prescribed for respiratory tract infections or the share of broad-spectrum drugs prescribed, was unchanged between high and low adopters.
Study co-author Dr Johannes Kunz, from Monash Business School's Centre for Health Economics, said that, importantly, the reduction in prescriptions did not mean lower prescribing quality.
Nor did it see doctors prescribe 'broad spectrum' antibiotics ahead of 'narrow spectrum' options that were more effective but required more patient analysis.
Dr Kunz said the results suggested telemedicine remained a good option for patients.
"This has important implications for governments considering how to fund digital care models, particularly as antimicrobial resistance remains a major global health challenge," he said.
Study co-authors included Dr Maria Wiśniewska, who conducted the research while completing her PhD at the Monash Business School and is now at Deakin University Business School, Professor Daniel Avdic from UTS and Dr Susan Méndez from the University of Melbourne.
Dr Wiśniewska said several potential explanations were ruled out.
"The decline in prescriptions is not driven by differences in patient selection, doctor shopping, or changes in consultation intensity," Dr Wiśniewska said.
"Instead, the findings are consistent with mechanisms that improve time efficiency and reduce patient pressure in remote environments, allowing GPs to schedule follow-ups rather than prescribe 'just in case'."
Dr Wiśniewska said the evidence suggested that fears of lower quality care in telemedicine were not supported in this context. "Telemedicine may simultaneously expand access, reduce unnecessary antibiotic use, and maintain prescribing standards," she said.
Full reference: Avdic D, Kunz JS, Méndez SJ, Wiśniewska M. Does telemedicine technology affect prescribing quality in primary care? The case of antibiotics. November 2025. Accepted for Publication. Journal of Health Economics.
Read the full article here: https://doi.org/10.1016/j.jhealeco.2025.103096
