Pillans P I, Conry I, Gie B E
Department of Pharmacology, University of Cape Town and Pharmacy Department, Groote Schuur Hospital, South Africa.
Pharmacoeconomics. 1992 May;1(5):377-82. doi: 10.2165/00019053-199201050-00009.
Faced with a reduction in the 1990-91 pharmaceutical budget despite escalating prices, decisive cost-saving measures had to be implemented in our 1500-bed state-funded teaching hospital. 15 drug categories were reviewed by the Medicines Control Committee in conjunction with specialist work groups based on a detailed audit of the previous year's pharmaceutical expenditure. The usage of medicines was rationalised by paying particular attention to expensive agents, substitution of less expensive alternatives, deletion of nonessential drugs from the formulary, restriction of certain medicines and by imposing fixed budgets. 65 items were deleted from the hospital formulary. The previous trend of an increase in annual expenditure was reversed during the 1990 to 1991 financial year; for the first time, it was less than the allocated budget. The 20 pharmaceuticals making the greatest contribution to the drug bill comprised 31% of total expenditure in the 1989 to 1990 financial year and 26% in 1990-91 and declined from R7.4 million to R5.7 million during this period, a decrease of 23%. A decrease in expenditure was realised in 14 of the 15 categories reviewed. Overall a 20% saving, or R3.3 million, was achieved for these categories.
面对1990 - 1991年药品预算削减，尽管药品价格不断上涨，我们这家拥有1500张床位的国立教学医院仍不得不实施果断的成本节约措施。药品控制委员会与各专业工作组一道，在对上一年药品支出进行详细审计的基础上，对15类药品进行了审查。通过特别关注昂贵药品、用较便宜的替代品替代、从处方中删除非必要药品、限制某些药品以及实施固定预算等方式，使药品使用合理化。医院处方中删除了65种药品。在1990至1991财政年度，年度支出持续增长的趋势得到扭转；年度支出首次低于分配预算。对药费贡献最大的20种药品在1989至1990财政年度占总支出的31%，在1990 - 91年度占26%，在此期间从740万兰特降至570万兰特，降幅为23%。在审查的15类药品中，有14类实现了支出减少。总体而言，这些类别实现了20%的节约，即330万兰特。
