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Hospitals have opportunities to reduce the use of expensive or hard-to-get drugs and save money without compromising patient care, according to Andrew Donnelly, director of pharmacy services at the University of Illinois Hospital and Health Science System (UI Health), who spoke at a meeting of the American Association for the Advancement of Science in Boston. His remarks are reported in an article posted on the HealthLeaders Media website.

Hospitals need to know that there may be feasible alternatives to medications that suddenly become much more expensive, Donnelly said. And if the alternative approaches are evidence-based, then they shouldn’t affect quality of care.

“You don’t necessarily have to continue using that very expensive medication in the same manner you do right now,” he said. “Keep the expensive medication for when there is absolutely no other alternative.”

By working with a team consisting of clinicians and representatives for pharmacy, finance, and administrators, UI Health developed strategies to substitute drugs, reduce waste, and develop guidelines, Donnelly reported. He offered the following suggestions:

  • Determine whether evidence-based alternatives to the high-priced drug are available. If so, remove the expensive drug from the formulary so that it can’t be ordered by health care providers, or establish guidelines for its approved uses.
  • Reduce waste associated with expensive drugs. This could include dose rounding, where the dose is reduced slightly to avoid having to use another vial for only a small amount of drug. Some hospitals do this with intravenous immunoglobulin, Donnelly said.
  • Make sure the size of infusion bags does not contribute to waste, and consider making multiple syringes out of one vial of an expensive drug if only small doses are needed.
  • Identify significant drug price increases as soon as possible to avoid delays in taking action, to minimize the financial impact.
  • Keep as low an inventory of the expensive drug as possible.
  • Maintain lines of communication with senior administrators, and let them know the negative effect high-priced medications are having on the drug budget.
  • Use clinical pharmacists to educate prescribers about inflated drug prices.

Source: HealthLeaders Media(link is external); February 23, 2017.

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