Pharmacy costs associated with nonformulary drug requests

Pharmacy costs associated with handling nonformulary drug requests were studied. Data for all nonformulary drug orders received at a university hospital between August 1 and October 31, 1999, were evaluated to determine their outcome and the cost differential between the nonformulary drug and formul...

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Bibliographic Details
Published in:American journal of health-system pharmacy 2001-09, Vol.58 (18), p.1746-1752
Main Authors: Sweet, BV, Stevenson, JG
Format: Article
Language:English
Subjects:
Biological and medical sciences
Drug Costs
Drug Prescriptions - economics
Formularies, Hospital as Topic
General aspects
Health and social institutions
Hospitals, University
Humans
Medical sciences
Michigan
Pharmacy Service, Hospital - economics
Public health. Hygiene
Public health. Hygiene-occupational medicine
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Summary:Pharmacy costs associated with handling nonformulary drug requests were studied. Data for all nonformulary drug orders received at a university hospital between August 1 and October 31, 1999, were evaluated to determine their outcome and the cost differential between the nonformulary drug and formulary alternative. Two sets of data were used to analyze medication costs: data from nonformulary medication request forms, which allowed the cost of nonformulary drugs and their formulary alternatives to be calculated, and data from the pharmacy computer system, which enabled actual nonformulary drug use to be captured. Labor costs associated with processing these requests were determined through time analysis, which included the potential for orders to be received at different times of the day and with different levels of technician and pharmacist support. Economic analysis revealed that the greatest cost saving occurred when converting nonformulary injectable products to formulary alternatives. Interventions were least costly during normal business hours, when all the satellite pharmacies were open and fully staffed. Pharmacists' interventions in oral product orders resulted in a net increase in expenditures. Incremental pharmacy costs associated with processing nonformulary medication requests in an inpatient setting are greater than the drug acquisition cost saving for most agents, particularly oral medications.
ISSN:1079-2082
1535-2900
DOI:10.1093/ajhp/58.18.1746