title: Evaluation of cost minimization strategies of anaesthetic drugs in a tertiary care hospital.
abstract: A survey was undertaken to compare anaesthetic drug expenditures over a three-year period, to evaluate the impact of strategies offered to curtain continuously rising drug costs. Suggestions to control rising expenditures were based primarily on education of staff and residents regarding drug costs, emphasizing rational use of the more expensive drugs, and minimizing drug wastage. To assess the impact of these measures, a review of annual hospital budgets, global pharmacy expenditures, and anaesthetic drug expenditures was conducted for the period 1991 to 1993. Both absolute and proportional costs of anaesthetic drugs were compared, by year, according to six major classes: opioid analgesics (OA), muscle relaxants (MR), inhalational anaesthetic drugs (INH), intravenous anaesthetic drugs (i.v.), local anaesthetic drugs (LA) and a category labelled other drugs (OTH). In addition, the utilization patterns and unit price changes were compared for each drug for the periods 1991-92, and 1992-93. Total hospital drug costs increased from $7.1 M to $8.5M over the three years. During the same period, the cost of anaesthetic drugs decreased from $379K to $361K, despite an augmentation in annual case load from 12,507 to 13,076 surgical procedures. For the entire survey period, the mean cumulative anaesthetic drug cost was 4.6% of the pharmacy budget, or 0.24% of the hospital budget. Analysis by drug class revealed a $51K decrease in expenditures on OA. due to decreased utilization of fentanyl and alfentanil, and a decrease in the price of fentanyl. The increased expenditure on INH drugs was primarily due to an increase in acquisition costs.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Anaesthesia, Ottawa General Hospital, Ontario.
authors.forename: C
authors.initials: C
authors.lastname: Hawkes
authors.forename: D
authors.initials: D
authors.lastname: Miller
authors.forename: R
authors.initials: R
authors.lastname: Martineau
authors.forename: K
authors.initials: K
authors.lastname: Hull
authors.forename: H
authors.initials: H
authors.lastname: Hopkins
authors.forename: M
authors.initials: M
authors.lastname: Tierney
mesh_terms: D000328:Adult; D015760:Alfentanil / Q000191:economics; D000701:Analgesics, Opioid / Q000191:economics; D000761:Anesthesia Department, Hospital / Q000191:economics; D000777:Anesthetics / Q000191:economics*; D018685:Anesthetics, Inhalation / Q000191:economics; D018686:Anesthetics, Intravenous / Q000191:economics; D000779:Anesthetics, Local / Q000191:economics; D002017:Budgets; D003363:Cost Control; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D004363:Drug Utilization; D017850:Economics, Pharmaceutical; D005069:Evaluation Studies as Topic; D005283:Fentanyl / Q000191:economics; D017721:Hospital Costs; D006785:Hospitals, University / Q000191:economics; D006801:Humans; D007318:Inservice Training; D007396:Internship and Residency; D008505:Medical Staff, Hospital / Q000193:education; D009125:Muscle Relaxants, Central / Q000191:economics; D010607:Pharmacy Service, Hospital / Q000191:economics
chemical_list: D000701:Analgesics, Opioid; D000777:Anesthetics; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D009125:Muscle Relaxants, Central; D015760:Alfentanil; D005283:Fentanyl