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在长期护理环境中,速效胰岛素类似物的安瓿瓶和预填充笔对药房预算的比较。

Comparison of vials and prefilled pens of a rapid-acting insulin analog on pharmacy budgets in a long-term care setting.

作者信息

Eby Elizabeth L, Smolen Lee J, Pitts Amber C, Krueger Linda A, Andrews Jeffrey Scott

机构信息

Economics and Health Policy, Medtronic, Inc., Minneapolis, Minnesota, USA.

出版信息

Consult Pharm. 2014 Dec;29(12):813-22. doi: 10.4140/TCP.n.2014.813.

Abstract

OBJECTIVE

Estimate budgetary impact for skilled nursing facility converting from individual patient supply (IPS) delivery of rapid-acting insulin analog (RAIA) 10-mL vials or 3-mL prefilled pens to 3-mL vials.

DESIGN

A budget-impact model used insulin volume purchased and assumptions of length of stay (LOS), daily RAIA dose, and delivery protocol to estimate the cost impact of using 3-mL vials.

SETTING

Skilled nursing facility.

PARTICIPANTS

Medicare Part A patients.

INTERVENTIONS

Simulations conducted using 12-month current and future scenarios. Comparisons of RAIA use for 13- and 28-day LOS.

MAIN OUTCOME MEASURES

RAIA costs and savings, waste reduction.

RESULTS

For patients with 13-day LOS using 20 units/day of IPS insulin, the model estimated a 70% reduction in RAIA costs and units purchased and a 95% waste reduction for the 3-mL vial compared with the 10-mL vial. The estimated costs for prefilled pen use were 58% lower than for use of 10-mL vials. The incremental savings associated with 3-mL vial use instead of prefilled pens was 28%, attributable to differences in per-unit cost of insulin in vials versus prefilled pens. Using a more conservative scenario of 28-day LOS at 20 units/day, the model estimated a 40% reduction in RAIA costs and units purchased, resulting in a 91% reduction in RAIA waste for the 3-mL vial, compared with 10-mL vial.

CONCLUSION

Budget-impact analysis of conversion from RAIA 10-mL vials or 3-mL prefilled pens to 3-mL vials estimated reductions in both insulin costs and waste across multiple scenarios of varying LOS and patient daily doses for skilled nursing facility stays.

摘要

目的

评估熟练护理机构从使用10毫升瓶装或3毫升预填充笔式速效胰岛素类似物(RAIA)的个体化患者供应方式转换为使用3毫升瓶装时的预算影响。

设计

一个预算影响模型,利用购买的胰岛素量以及住院时间(LOS)、每日RAIA剂量和给药方案的假设来估计使用3毫升瓶装的成本影响。

设置

熟练护理机构。

参与者

医疗保险A部分患者。

干预措施

使用12个月的当前和未来情景进行模拟。比较13天和28天住院时间的RAIA使用情况。

主要结局指标

RAIA成本和节省情况、减少的浪费。

结果

对于住院13天、每天使用20单位个体化患者供应胰岛素的患者,该模型估计与10毫升瓶装相比,3毫升瓶装的RAIA成本和购买单位减少70%,浪费减少95%。预填充笔的估计成本比使用10毫升瓶装低58%。使用3毫升瓶装而非预填充笔的增量节省为28%,这归因于瓶装胰岛素与预填充笔的单位成本差异。在更保守的情景下,住院28天、每天使用20单位,该模型估计RAIA成本和购买单位减少40%,与10毫升瓶装相比,3毫升瓶装的RAIA浪费减少91%。

结论

对从10毫升瓶装或3毫升预填充笔式RAIA转换为3毫升瓶装进行的预算影响分析估计,在熟练护理机构住院的多种住院时间和患者每日剂量情景下,胰岛素成本和浪费均会降低。

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