title: Therapeutic substitution of cimetidine for nizatidine was not associated with an increase in healthcare utilization.
abstract: OBJECTIVE
  To examine changes in healthcare utilization resulting from a formulary switch to cimetidine from nizatidine at the Veterans Affairs Pittsburgh Healthcare System.
  
  
  METHODS
  A retrospective analysis of administrative and clinical data 6 months before and 6 months after the therapeutic substitution.
  
  
  METHODS
  The 704 patients who were switched from nizatidine to cimetidine were included in the study. Administrative data included total and primary care clinic visits, emergency room visits, gastrointestinal (GI)-related radiological studies, and GI endoscopic procedures. Discharge summaries were examined, and rates of total and GI-related hospitalizations were calculated.
  
  
  RESULTS
  There was no evidence of increased utilization of healthcare resources during the 6 months after the formulary switch. Estimated monthly pharmaceutical savings for the Veterans Affairs Pittsburgh Healthcare System were $7260.
  
  
  CONCLUSIONS
  A formulary switch from nizatidine to cimetidine can be accomplished at significant pharmaceutical cost savings, and this retrospective study suggests that this can be done without increasing other aspects of healthcare resource utilization.
authors.affiliation: Veterans Affairs Pittsburgh Healthcare System, PA 15240, USA. chester.good@med.va.gov
authors.forename: C B
authors.initials: CB
authors.lastname: Good
authors.forename: S L
authors.initials: SL
authors.lastname: Fultz
authors.forename: L
authors.initials: L
authors.lastname: Trilli
authors.forename: J
authors.initials: J
authors.lastname: Etchason
mesh_terms: D000368:Aged; D002927:Cimetidine / Q000008:administration & dosage* / Q000191:economics; D017046:Cost Savings; D016527:Drug Costs; D004381:Duodenal Ulcer / Q000188:drug therapy*; D005572:Formularies, Hospital as Topic; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006302:Health Services Research; D006635:Histamine H2 Antagonists / Q000008:administration & dosage* / Q000191:economics; D006787:Hospitals, Veterans / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016567:Nizatidine / Q000008:administration & dosage* / Q000191:economics; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D010414:Pennsylvania; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000188:drug therapy*; D013810:Therapeutic Equivalency
chemical_list: D006635:Histamine H2 Antagonists; D002927:Cimetidine; D016567:Nizatidine