title: Reverse auction: a potential strategy for reduction of pharmacological therapy cost.
abstract: BACKGROUND
  Polypharmacy is a significant economic burden.
  
  
  OBJECTIVE
  We tested whether using reverse auction (RA) as compared with commercial pharmacy (CP) to purchase medicine results in lower pharmaceutical costs for heart failure (HF) and heart transplantation (HT) outpatients.
  
  
  METHODS
  We compared the costs via RA versus CP in 808 HF and 147 HT patients followed from 2009 through 2011, and evaluated the influence of clinical and demographic variables on cost.
  
  
  RESULTS
  The monthly cost per patient for HF drugs acquired via RA was $10.15 (IQ 3.51-40.22) versus $161.76 (IQ 86.05‑340.15) via CP; for HT, those costs were $393.08 (IQ 124.74-774.76) and $1,207.70 (IQ 604.48-2,499.97), respectively.
  
  
  CONCLUSIONS
  RA may reduce the cost of prescription drugs for HF and HT, potentially making HF treatment more accessible. Clinical characteristics can influence the cost and benefits of RA. RA may be a new health policy strategy to reduce costs of prescribed medications for HF and HT patients, reducing the economic burden of treatment.
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, BR.
authors.forename: Sara Michelly Gonçalves
authors.initials: SM
authors.lastname: Brandão
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, BR.
authors.forename: Victor Sarli
authors.initials: VS
authors.lastname: Issa
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, BR.
authors.forename: Silvia Moreira
authors.initials: SM
authors.lastname: Ayub-Ferreira
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, BR.
authors.forename: Samantha
authors.initials: S
authors.lastname: Storer
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, BR.
authors.forename: Bianca Gigliotti
authors.initials: BG
authors.lastname: Gonçalves
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, BR.
authors.forename: Valter Garcia
authors.initials: VG
authors.lastname: Santos
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, BR.
authors.forename: Nelson
authors.initials: N
authors.lastname: Carvas Junior
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, BR.
authors.forename: Guilherme Veiga
authors.initials: GV
authors.lastname: Guimarães
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, BR.
authors.forename: Edimar Alcides
authors.initials: EA
authors.lastname: Bocchi
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil; D003164:Competitive Bidding / Q000191:economics*; D003363:Cost Control; D003362:Cost-Benefit Analysis; D016527:Drug Costs / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000191:economics; D004358:Drug Therapy / Q000191:economics*; D006333:Heart Failure / Q000188:drug therapy / Q000191:economics*; D016027:Heart Transplantation / Q000191:economics*; D006801:Humans; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013318:Stroke Volume; D016277:Ventricular Function, Left; D055815:Young Adult