Mahmoudi Laleh, Karamikhah Razieh, Mahdavinia Azadeh, Samiei Hasan, Petramfar Peyman, Niknam Ramin
From the Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran (LM, RK, AM), Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran (HS), Department of Neurology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran (PP); and Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran (RN).
Medicine (Baltimore). 2015 Oct;94(42):e1744. doi: 10.1097/MD.0000000000001744.
All around the world a few studies have been found on the effect of guideline implementation on direct medications' expenditure. The goal of this study was to evaluate cost savings of guideline implementation among patients who had to receive 3 costly medications including albumin, enoxaparin, and pantoprazole in a tertiary hospital in Shiraz, Iran.An 8-month prospective study was performed in 2 groups; group 1 as an observational group (control group) in 4 months from June to September 2014 and group 2 as an interventional group from October 2014 to January 2015.For group 1 the pattern of costly medications usage was determined without any intervention. For group 2, after guideline implementation, the economic impact was evaluated by making comparisons between the data achieved from the 2 groups.A total of 12,680 patients were evaluated during this study (6470 in group 1; 6210 in group 2). The reduction in the total value of costly administered drugs was 56% after guideline implementation. Such reduction in inappropriate prescribing accounts for the saving of 85,625 United States dollars (USD) monthly and estimated 1,027,500 USD annually.Guideline implementation could improve the adherence of evidence-based drug utilization and resulted in significant cost savings in a major teaching medical center via a decrease in inappropriate prescribing of costly medications.
世界各地都有一些关于指南实施对直接药物支出影响的研究。本研究的目的是评估在伊朗设拉子的一家三级医院中,指南实施对必须接受包括白蛋白、依诺肝素和泮托拉唑在内的三种昂贵药物治疗的患者的成本节约情况。
进行了一项为期8个月的前瞻性研究,分为两组;第1组为观察组(对照组),时间为2014年6月至9月的4个月,第2组为干预组,时间为2014年10月至2015年1月。
对于第1组,在没有任何干预的情况下确定昂贵药物的使用模式。对于第2组,在指南实施后,通过比较两组获得的数据来评估经济影响。
在本研究期间共评估了12680名患者(第1组6470名;第2组6210名)。指南实施后,昂贵给药药物的总价值降低了56%。这种不适当处方的减少每月节省85625美元(USD),估计每年节省1027500美元。
指南实施可以提高循证药物使用的依从性,并通过减少昂贵药物的不适当处方,在一家大型教学医疗中心实现显著的成本节约。