Abramowitz P W
Am J Hosp Pharm. 1984 Mar;41(3):503-15.
Techniques of formulary management, pharmacy and therapeutics committee intervention, and the use of clinical pharmacy services to change prescribing patterns and contain costs in hospital pharmacy departments are reviewed. Methods of using the formulary to contain costs include deletion of generic and therapeutic equivalents, inclusion of therapeutic categories and cost codes, and regular reviews and updates of its contents. Drug monographs for formulary evaluation prepared for the P & T committee should include a comparative review of other drugs in the therapeutic category and a cost impact statement. The P & T committee can help contain costs by developing policies for automatic stop orders and restricted drug use. Clinical pharmacy activities that can result in cost savings include physician education (focused on prescribing), target drug programs, target disease programs, pharmacist participation on TPN and i.v. therapy teams, and patient training programs for home care. A matrix for evaluating cost-containment activities is presented. By tailoring the described methods to departmental personnel resources and hospital needs, the pharmacy can be effective in controlling costs.
本文回顾了医院药房部门中处方集管理、药学与治疗学委员会干预以及利用临床药学服务来改变处方模式和控制成本的技术。利用处方集控制成本的方法包括删除通用名药物和治疗等效物、纳入治疗类别和成本代码，以及定期审查和更新其内容。为药学与治疗学委员会准备的用于处方集评估的药物专论应包括对治疗类别中其他药物的比较审查和成本影响声明。药学与治疗学委员会可以通过制定自动停药医嘱和限制药物使用的政策来帮助控制成本。能够节省成本的临床药学活动包括医师教育（侧重于处方）、目标药物项目、目标疾病项目、药师参与全胃肠外营养和静脉治疗团队，以及家庭护理患者培训项目。本文还给出了一个评估成本控制活动的矩阵。通过根据部门人员资源和医院需求调整所描述的方法，药房能够有效地控制成本。
