title: Changing patterns in volatile anaesthetic agent consumption over seven years in Victorian public hospitals.
abstract: Evidence-based choices of volatile agents can increase health cost efficiencies. In this pharmaco-economic study, we evaluated the trends and costs of volatile agent use in Australian public hospitals. The total number of volatile agent (isoflurane, sevoflurane and desflurane) bottles ordered and inflation-adjusted costs were collected from 65 Victorian public hospitals from 2005 to 2011. Environmental costs were measured through the 100-year global warming potential index as carbon dioxide equivalents. During this time period, the aggregate inflation-adjusted expenditure was $39,209,878. Time series analysis showed that bottles of isoflurane ordered decreased by 419/year (99% confidence interval (CI): -603 to -235); costs decreased by $56,017/year (99% CI: -$93,243 to -$18,791). Bottles of sevoflurane increased by 1,330/year (99% CI: 1141 to 1,519); costs decreased by $423,3573/year (99% CI: -$720,030 to -112,783). Bottles of desflurane increased by 726/year (99% CI: 288 to 1,164); costs increased by $171,578/year (99% CI: $136,951 to $206,205). The amount of calculated greenhouse gas emissions released into the atmosphere over this period was 37,000 tonnes of carbon dioxide equivalents, with isoflurane contributing 6%, sevoflurane 17%, and desflurane 77% of this total. In conclusion, isoflurane is no longer being used in the majority of Victorian public hospitals, with sevoflurane and desflurane remaining as the primary volatile agents, utilised respectively at a ratio of 2.2 to 1, and costs at 0.8 to 1.
authors.affiliation: Department of Anaesthesia, Austin Hospital, Heidelberg, Victoria.
authors.forename: L
authors.initials: L
authors.lastname: Weinberg
authors.forename: S
authors.initials: S
authors.lastname: Tay
authors.forename: V
authors.initials: V
authors.lastname: Aykanat
authors.forename: R
authors.initials: R
authors.lastname: Segal
authors.forename: C O
authors.initials: CO
authors.lastname: Tan
authors.forename: P
authors.initials: P
authors.lastname: Peyton
authors.forename: L
authors.initials: L
authors.lastname: McNicol
authors.forename: D A
authors.initials: DA
authors.lastname: Story
mesh_terms: D018685:Anesthetics, Inhalation / Q000191:economics*; D001315:Australia; D016527:Drug Costs; D057232:Global Warming; D006779:Hospitals, Public; D006801:Humans
chemical_list: D018685:Anesthetics, Inhalation
keywords: anaesthetics; attention; cost control; health expenditures; inhalation