Albumin/Hetastarch Drug Utilization Review in an Operating Room Pharmacy

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.

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Cost Comparison of Atypical Antipsychotics: Paliperidone ER and Risperidone

Hospital Pharmacy ◽

10.1177/0018578718809269 ◽

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.

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

Curationis ◽

10.4102/curationis.v21i4.684 ◽

1998 ◽

Vol 21 (4) ◽

Cited By ~ 1

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.

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

Annals of Pharmacotherapy ◽

10.1177/106002809603001004 ◽

1996 ◽

Vol 30 (10) ◽

pp. 1088-1091 ◽

Cited By ~ 2

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.

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