Simple method to detect factors influencing drug expenditures
Lustig, A.
Harefuah 143(1): 28-32; 85
2004
ISSN/ISBN: 0017-7768 PMID: 14748285 Document Number: 575777
Analysis of drug expenditures as part of an assessment of various forms of management interventions is rarely reported. Several strategies have been used to decrease injudicious drug use: restricted availability of specific drugs under formulary instructions, educational programs for prescribing practices and streamlining to discontinue or limit therapy. Each intervention has limited effectiveness. To detect factors influencing drug expenditures by a simple and accessible method. Data analysis on drug utilization and expenditures was performed according to the "Pareto" technique and changes were calculated. Changes in expenditure due to inflation were also calculated; the cost value of each drug in 2000 was multiplied by its quantity used in years 2000 and 2001. Comparison of expenditures using this method of calculation enabled us to find the inflation rate of the drugs used in the hospital. Five important factors were found to have an impact on the pharmacy budget and calculations: drug inflation rate (-1%), new drugs introduced through the Pharmaceuticals & Therapeutic Committee (1.9%), extended usage of drugs due to new approved clinical indications (0.7%), opening of new services or widening of special old services (3.4%) and usage of commonly high volume prescribed drugs in various wards of the hospital (-8.9%). Quantities and costs for the 80 most expensive pharmaceuticals showed factors responsible for the drug expenditure when compared with the leading drug classes, as well as with leading drugs. Antimicrobials (27.5%), high volume IV infusions (11.0%), small volume infusions (8.5%), and anticoagulants (6.7%) were the most prominent drug classes that contributed to the high cost of the drug budget. Small volume infusions of Sodium Chloride 0.9% (7.8%), Piperacillin and tazobactam injections (5.6%). Ofloxacin & Ciprofloxacin drugs (4.7%), and Enoxaparin injections (4.6%) were the highest costing drugs. This simple method based on comparison of costs, utilization and judicious drug use, can provide accurate information that can be useful in planning and implementing a reasonable drug budget.