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Switching patients from IV to oral form of drugs could save millions, reduce adverse events
Switching hospitalized patients able to take medication by mouth from intravenous to pill forms of the same drugs could safely save millions of dollars a year.
In a review of computerized records for the year 2010, conducted at The Johns Hopkins Hospital in Baltimore, researchers estimated savings of more than $1.1 million in the Department of Medicine alone-not including surgical patients-by swapping out 4 commonly prescribed IV medications with their oral equivalents.
The medications reviewed in the study were chlorothiazide (a medication used to treat high blood pressure and address fluid retention), voriconazole (an anti-fungal), levetiracetam (to stop seizures) and pantoprazole (for acid reflux).
"Assuming that all patients were indeed eligible for the equivalent oral medication, the use of IV medication contributes to more than $1.16 million in medication acquisition cost alone," said Dr Lau.
By combining Hopkins' computerized provider order entry (CPOE) system, researchers examined whether patients receiving these drugs intravenously were also prescribed other medications orally or if they were being fed solid meals, another indication that they would likely be able to swallow pills. In 2010, a total of 10,905 doses of the 4 medications were given by IV to patients admitted through the Department of Medicine. Dr Lau said the drugs are given even more frequently in surgery patients.
By developing an electronic reminder in the CPOE that alerts the prescriber of potential clinical eligibility for oral medication, "there may be a reduction in the use of IV medication, the cost of acquiring and administering IV medication, and adverse events such as IV-associated bloodstream infection," he explained. "Health IT, in the form of electronic medical records, CPOE, and clinical decision support systems, and its meaningful use is a national priority. These are tools that are being adopted by hospitals across the country. This study is one example of the potential impact that health IT could have on cost reduction and quality improvement."
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
