scholarly journals Cost Comparison of Atypical Antipsychotics: Paliperidone ER and Risperidone

2018 ◽  
Vol 54 (6) ◽  
pp. 389-392
Author(s):  
Kiranjit Luther ◽  
Guang Mei Fung ◽  
Farah Khorassani
Keyword(s):  
Drug Utilization ◽  
Atypical Antipsychotics ◽  
Cost Savings ◽  
Cost Comparison ◽  
Prescribing Patterns ◽  
Utilization Review ◽  
Drug Utilization Review ◽  
Potential Cost ◽  
Therapy Cost ◽  
The Cost

Purpose: Paliperidone and risperidone are atypical antipsychotics that are structurally and therapeutically similar. Risperidone is metabolized by the liver via cytochrome (CYP) 2D6 to an active metabolite, 9-hydroxyrisperidone. The atypical antipsychotic paliperidone is 9-hydroxyrisperidone formulated separately as an extended-release (ER) tablet and is considerably more expensive than risperidone. The purpose of this retrospective drug utilization review is to evaluate the prescribing patterns of paliperidone ER and evaluate potential cost savings by converting paliperidone ER orders to risperidone at an inpatient psychiatric hospital’s formulary. Methods: This retrospective drug utilization review includes 100 patients, older than 18 years old, who were prescribed oral paliperidone ER at an inpatient, psychiatric hospital between January 1, 2017, and June 2, 2017. The data were collected through the electronic medical records. Patients who were prescribed oral paliperidone ER and refused to take paliperidone ER were excluded from the study population. The cost of each patient’s oral paliperidone ER pharmacotherapy was calculated using average wholesale prices. An equivalent total dose of risperidone therapy was calculated using a 2:3 paliperidone ER to risperidone conversion. The cost savings were then analyzed by comparing the total costs of paliperidone ER with risperidone therapy. Results: The results indicate that from January through June 2017, approximately 68% of all paliperidone ER utilization was for its approved indication of schizophrenia and schizoaffective disorder. The other 32% of utilization was either off-label or for approved indications of risperidone. The total paliperidone ER therapy cost for 100 patients was approximately $17 000, while the cost of risperidone therapy would be approximately $400 for the same patients over 6 months. Overall, this would provide an estimated cost savings of over $33 000 per year or about $169 in savings per patient. Conclusion: The study analysis demonstrates that there are opportunities for cost savings through therapeutic interchange of paliperidone ER to risperidone.

scholarly journals The cost-effectiveness of managed care regarding chronic medicine prescriptions in a selected medical scheme

Curationis ◽  
1998 ◽  
Vol 21 (4) ◽  
Author(s):  
K. Day ◽  
S. Booyens
Keyword(s):  
Cost Effectiveness ◽  
Chronic Illness ◽  
Managed Care ◽  
Drug Utilization ◽  
Cost Savings ◽  
Utilization Review ◽  
Drug Utilization Review ◽  
Real Cost ◽  
The Cost

The purpose of the study was to examine the cost-effectiveness of managed care interventions with respect to prescriptions for chronic illness sufferers enrolled with a specific medical scheme. The illnesses included, were epilepsy, hypertension, diabetes and asthma. The managed care interventions applied were a primary discount; the use of preferred provider pharmacies, and drug utilization review. It was concluded that the managed care interventions resulted in some real cost savings.

scholarly journals 2694. Incidence of Pneumocytis jiroveci (PJP) Infection with 3-Month Prophylaxis of Aerosolized Pentamidine (AP) in Autologous Hematopoietic Stem Cell Transplantation (HSCT)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S947-S947
Author(s):  
Sarah Perreault ◽  
Dayna McManus ◽  
Rebecca Pulk ◽  
Jeffrey E Topal ◽  
Francine Foss ◽  
...  
Keyword(s):  
Cost Savings ◽  
Cost Comparison ◽  
High Dose ◽  
Potential Cost ◽  
Hematopoietic Stem ◽  
Increased Risk ◽  
One Year ◽  
Relapsed Disease ◽  
The Cost ◽  
Autologous Hsct

Abstract Background HSCT patients are at an increased risk of developing PJP after transplant due to treatment induced immunosuppression. Given the risk of cytopenias with co-trimoxazole, AP is utilized as an alternative for PJP prophylaxis. A prior study revealed a 0% (0/19 patients) incidence when AP prophylaxis was given for one year post autologous HSCT. Current guidelines recommend a duration of 3 – 6 months for PJP prophylaxis in autologous HSCT. The primary endpoint of this study was to assess the incidence of PJP infection within one year post autologous HSCT in patients who received 3 months of AP. Secondary endpoint was a cost comparison of 3 months compared with 6 months of AP. Methods A single-center, retrospective study of adult autologous HSCT patients at Yale New Haven Hospital between February 2013 and December 2017 was performed. Patients were excluded if: <18 years of age, received < or >3 months of AP, changed to alternative PJP prophylactic agent or received no PJP prophylaxis, received tandem HSCT, deceased prior to one year post-transplant from a non PJP-related infection, HIV positive, or lost to follow-up. Pentamidine was given as a 300 mg inhalation monthly for 3 months starting Day +15 after autologous HSCT. Results A total of 288 patients were analyzed, no PJP infections occurred within one year post HSCT. Additionally, 187 (65%) patients received treatment post HSCT with 135/215 (63%) receiving maintenance immunomodulatory drugs for myeloma and 40/288 (14%) patients developing relapsed disease. 43% of the chemotherapy regimens for relapsed disease included high dose corticosteroids. The cost difference of using 3 months vs. 6 months of AP is $790, reflecting the cost of drug and its administration. Applying our incidence of 0%, potential cost savings of 3 months vs. 6 months of AP would be $330,000 over 5 years or $66,000 per year. Conclusion Three months of AP for PJP prophylaxis in autologous HSCT patients is safe and effective as well as cost-effective compared with a 6 month regimen. Disclosures All authors: No reported disclosures.

Albumin/Hetastarch Drug Utilization Review in an Operating Room Pharmacy

1987 ◽  
Vol 21 (3) ◽  
pp. 286-289 ◽  
Author(s):  
Andrew J. Donnelly
Keyword(s):  
Operating Room ◽  
Drug Utilization ◽  
Cost Savings ◽  
Utilization Review ◽  
Drug Utilization Review ◽  
University Of Illinois ◽  
Usage Patterns ◽  
The Individual ◽  
The University

A prospective drug utilization review (DUR) was performed on the colloids albumin 5% and hetastarch 6% at the University of Illinois Hospital Operating Room Pharmacy. This DUR's purpose was to evaluate the usage patterns of the two colloids. With the addition of hetastarch 6% to the formulary, an alternative colloid was available that could be therapeutically substituted for albumin 5% at a cost savings. Its usage, however, was not what would have been expected. Usage information was obtained by placing utilization forms inside the individual boxes of albumin 5% and hetastarch 6%. These forms were completed by the anesthesiologists and returned to the pharmacy, where the remainder of each form was completed. It was concluded that 93 percent of the patients administered albumin 5% could have received hetastarch 6%. Hence, potential yearly savings of approximately $12 346.00 could be realized by the Department of Pharmacy.

An Assessment of Prescribing Using Drug Utilization Review Criteria

1982 ◽  
Vol 16 (12) ◽  
pp. 930-934 ◽  
Author(s):  
Dennis K. Helling ◽  
G. Joseph Norwood ◽  
John D. Donner
Keyword(s):  
Medical School ◽  
Drug Utilization ◽  
Negative Relationship ◽  
Prescribing Patterns ◽  
Utilization Review ◽  
Drug Utilization Review ◽  
Screening Criteria ◽  
The Relationship ◽  
Explicit Criteria ◽  
Review Criteria

Drug utilization review screening criteria were applied to a sample of 30000 prescriptions written by Iowa physicians. Characteristics of the physicians who had high percentages of prescriptions violating the explicit criteria were examined. It was found that the proportion of prescriptions failing the screening criteria did not differ significantly among physicians of differing board certification groups, medical school of graduation, year of graduation from medical school, age, or size of town where the physicians practiced. Regardless of the physicians' demographic characteristics, approximately 50 percent of their prescriptions violated the prescribing criteria. The three categories of screening criteria included irrational mixture, quantity prescribed, and daily dosage. An analysis of the relationship between physician ratings obtained for each of the categories revealed that no relationship existed between a physician's quantity prescribed rating and daily dosage rating, or between a physician's irrational mixture rating and daily dosage rating. A negative relationship was found between a physician's quantity prescribed rating and irrational mixture rating. This tends to indicate that the three categories measure different prescribing patterns and each warrants respective monitoring by pharmacists.

Plastic Liners for Offshore Production Lines: A Cost Effective Alternative Solution to Corrosion Resistant Alloys?

2021 ◽  
Author(s):  
Thomas Delaplace ◽  
Morgan Gouriou ◽  
Denis Melot
Keyword(s):  
Cost Savings ◽  
Cost Effective ◽  
Sensitivity Study ◽  
Cost Comparison ◽  
Production Lines ◽  
Potential Cost ◽  
Corrosion Resistant ◽  
Offshore Production ◽  
Design Requirements ◽  
The Cost

Abstract This paper presents the investigations performed by TotalEnergies and Saipem on the cost effectiveness potential of internal plastic lining for corrosion protection of offshore production lines. Objective was to better understand for a complete EPCI cost comparison the various parameters that could have a significant impact on the potential savings associated with the use of plastic lining instead of CRAs (Corrosion Resistant Alloys) for very corrosive production fluids such as sour gases. An extensive cost comparison study between CRA lining and plastic lining for offshore production lines was performed considering sensitivity on several parameters: 3 pipe diameters, S-Lay, Reel-Lay and J-Lay installation, sensitivity to external thermal insulation requirements, mechanical and design requirements, to pipe length and fixed costs (technologies and vessels). A dedicated calculation tool for system design and cost assessment was built on purpose for this sensitivity study. Costs were assessed for the various cases, starting from pipe design, then assessing procurement costs, fabrication costs then installation costs with preliminary cycle time assessment. Project management and engineering costs have been considered to obtain comparative EPCI (as installed) cost assessments for the various study cases. Plastic lining appears to be a cost-effective solution installed in J-Lay or S-Lay in addition to reeling (up to 45% of potential cost savings on installed line compared to CRA lining). The main driver for the cost savings is associated to the procurement of the pipes and associated lining, including pipe manufacturing. Some smaller savings can also be obtained from the offshore cycle times in J-Lay and S-Lay as the CRA welding add a significant operation time in comparison with standard CS welds. The fixed additional costs associated to the plastic lining (specific tooling for example) can be quickly amortized after a few kilometers thanks to the material cost savings. Integrating them as a company investment allows to unlock costs savings even for shorter lines. The thermal contribution of the plastic liner is also interesting regarding the overall pipe insulation design. This study completes the works already performed by the industry on the offshore costs of plastic lining as it considers the whole EPCI CAPEX costs from the Contractor and Operator points of view and offshore experience. The study integrates the S-Lay and J-Lay installation methods (while previous studies mainly focused on Reel-Lay) and includes an extensive sensitivity study with various key parameters such as pipe sizes, pipe design requirements, material costs and offshore operation times to get a general overview of potential benefits associated with plastic linings for offshore production lines transporting corrosive fluids such as sour gases.

scholarly journals Improving Prescribing Patterns for the Elderly Through an Online Drug Utilization Review Intervention

JAMA ◽  
1998 ◽  
Vol 280 (14) ◽  
pp. 1249 ◽  
Author(s):  
Mark Monane ◽  
Dipika M. Matthias ◽  
Becky A. Nagle ◽  
Miriam A. Kelly
Keyword(s):  
Drug Utilization ◽  
The Elderly ◽  
Prescribing Patterns ◽  
Utilization Review ◽  
Drug Utilization Review

Retrospective Drug Utilization Review Software Systems: Perspectives of State Medicaid Dur Directors

1996 ◽  
Vol 30 (10) ◽  
pp. 1088-1091 ◽  
Author(s):  
Edward P. Armstrong ◽  
Diane Proteau
Keyword(s):  
Drug Utilization ◽  
False Positive ◽  
Cost Savings ◽  
Software Systems ◽  
Utilization Review ◽  
Drug Utilization Review ◽  
Perceived Need ◽  
Critical Issues ◽  
To Receive ◽  
System Characteristics

OBJECTIVE: To determine the desirability or perceived need of retrospective drug utilization review (DUR) software system characteristics. DESIGN: A 32-item questionnaire. SETTING: Ambulatory DUR directors covering more than 33 million patients. PARTICIPANTS: Medicaid DUR directors from 49 states and the District of Columbia. MAIN OUTCOME MEASURES: Five-point Likert scale measures of importance of system and vendor characteristics. RESULTS: A 100% response rate was achieved. Respondents rated the ability to change or modify criteria as very important and thought it was important to receive criteria sets from software vendors. Respondents believed cost-savings methodologies should be clearly defined and false positive DUR criteria should be minimized. CONCLUSIONS: Through the implementation of the Omnibus Budget Reconciliation Act of 1990, considerable experience in ambulatory DUR programs has been achieved. Respondents believed the ability to change DUR criteria was very important and they thought it was important to have a set of criteria supplied from software vendors. Critical issues of criteria development, cost-savings methodologies, minimizing false positive criteria, and outcomes assessment from DUR programs were important issues to DUR directors.

Cost Comparison of Fan-out Wafer-Level Packaging to Fan-out Panel-Based Packaging

2016 ◽  
Vol 2016 (1) ◽  
pp. 000180-000184 ◽  
Author(s):  
Chet Palesko ◽  
Amy Lujan
Keyword(s):  
Surface Area ◽  
Cost Savings ◽  
Cost Comparison ◽  
Wafer Level ◽  
Potential Cost ◽  
Total Potential ◽  
Wafer Level Packaging ◽  
Cost Impact ◽  
Manufacturing Activity ◽  
The Cost

Abstract Fan-out wafer-level packaging (FOWLP) offers many significant benefits over other packaging technologies. It is one of the smallest packaging options, but unlike fan-in wafer-level packaging, the IO count of FOWLP is not limited to the area of the die. Given these advantages, FOWLP continues to grow in popularity. While the cost of FOWLP is usually reasonable, there are still opportunities for future cost reduction. Many FOWLP suppliers are exploring panel-based manufacturing instead of the current wafer-based approach. Since many more packages can fit on a large panel than on a wafer, the cost per package can be reduced. The surface area of a 370mm × 470mm panel is 1,739 sq.cm. compared to 706 sq.cm. for a 300mm wafer. This means more than twice as many packages can be manufactured on a single panel. However, this does not mean that the cost per package will be cut in half. Many of the costly manufacturing activities do not depend on the surface area of the panel or wafer and they will not be affected by a larger panel. This paper analyzes the current cost of FOWLP activities and highlights which activities will benefit from a move to panels. An analysis of each manufacturing activity is presented comparing the cost impact of panel versus wafer. The total potential cost savings is also presented.

Evaluation of Appropriateness and Interpretation of Serum Theophylline Assays

1985 ◽  
Vol 19 (5) ◽  
pp. 380-384 ◽  
Author(s):  
Christine Sargenti ◽  
Lawrence Zelman ◽  
Therese Beauclair ◽  
Elwyn Garrard ◽  
Ralph Boehm
Keyword(s):  
Audit Committee ◽  
Cost Savings ◽  
Sampling Time ◽  
Utilization Review ◽  
Medical Resident ◽  
Drug Utilization Review ◽  
Appropriate Use ◽  
Significant Cost ◽  
Serum Theophylline ◽  
The Cost

A drug utilization review of serum theophylline assays was undertaken to: (1) evaluate the prescriben' usage and interpretation of serum theophylline levels (STLs), and (2) calculate the cost of inappropriate assays. Criteria for appropriate use and interpretation were defined by an audit committee and approved by the chief medical resident. STLs were evaluated on medicine patients for a one-month period. Results of 102 levels ordered showed that 47 percent were inappropriate. The reasons cited most often for inappropriateness were: (1) previously-known STLs with no reason to expect a change in subsequent levels (26 percent); and (2) STLs drawn prior to steady state (12 percent). None of the levels evaluated had a request entered for the sampling time to be recorded. STLs were interpreted with the same degree of accuracy regardless of whether they were ordered appropriately. Results from this study suggest significant cost savings can be realized if physicians' ordering habits are corrected.

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