title: Potential savings of harmonising hospital and community formularies for chronic disease medications initiated in hospital.
abstract: BACKGROUND
  Hospitals in Canada manage their formularies independently, yet many inpatients are discharged on medications which will be purchased through publicly-funded programs. We sought to determine how much public money could be saved on chronic medications if hospitals promoted the initiation of agents with the lowest outpatient formulary prices.
  
  
  METHODS
  We used administrative databases for the province of Ontario to identify patients initiated on a proton pump inhibitor (PPI), angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) following hospital admission from April 1(st) 2008-March 31(st) 2009. We assessed the cost to the Ontario Drug Benefit Program (ODB) over the year following initiation and determined the cost savings if prescriptions were substituted with the least expensive agent in each class.
  
  
  RESULTS
  The cost for filling all PPI, ACE inhibitor and ARB prescriptions was $ 2.48 million, $968 thousand and $325 thousand respectively. Substituting the least expensive agent could have saved $1.16 million (47%) for PPIs, $162 thousand (17%) for ACE inhibitors and $14 thousand (4%) for ARBs over the year following discharge.
  
  
  CONCLUSIONS
  In a setting where outpatient prescriptions are publicly funded, harmonising outpatient formularies with inpatient therapeutic substitution resulted in modest cost savings and may be one way to control rising pharmaceutical costs.
authors: Department of Medicine, University of Toronto, Toronto, Ontario.
authors: Lauren
authors: L
authors: Lapointe-Shaw
authors: Hadas D
authors: HD
authors: Fischer
authors: Alice
authors: A
authors: Newman
authors: Ava
authors: A
authors: John-Baptiste
authors: Geoffrey M
authors: GM
authors: Anderson
authors: Paula A
authors: PA
authors: Rochon
authors: Chaim M
authors: CM
authors: Bell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002908:Chronic Disease; D017046:Cost Savings; D005260:Female; D005569:Formularies as Topic; D005572:Formularies, Hospital as Topic; D006801:Humans; D008297:Male
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors