Analysis of Nonformulary Use of PPIs and Excess Drug Cost in a Veterans Affairs Population

Ajumobi, Adewale; Vuong, Ronald; Ahaneku, Hycienth

doi:10.18553/jmcp.2012.18.1.63

Cited by 3 publications

(4 citation statements)

References 17 publications

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“…The formulary management pharmacists are integrally involved with restricted drug consult adjudication, as well as with consult and policy development, administrative functions, and other responsibilities. The decentralized pharmacists function available studies evaluate specific interventions, such as formulary conversion, [16][17][18][19] or focus on a more lenient formulary management approach. [19][20] The purpose of this study was to evaluate economic outcomes of a pharmacist-adjudicated formulary management consult service in a VA medical center offering outpatient and inpatient services.…”

Section: What This Study Addsmentioning

confidence: 99%

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Economic Outcomes Associated with a Pharmacist-Adjudicated Formulary Consult Service in a Veterans Affairs Medical Center

Britt

Hashem

Bryan

et al. 2016

JMCP

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Section: What This Study Addsmentioning

confidence: 99%

“…[10][11][12][13][14][15] However, there is a paucity of data regarding the economic impact of clinical pharmacist involvement in formulary management. [16][17][18][19][20]…”

mentioning

confidence: 99%

Economic Outcomes Associated with a Pharmacist-Adjudicated Formulary Consult Service in a Veterans Affairs Medical Center

Britt

Hashem

Bryan

et al. 2016

JMCP

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“…Thus, whilst pharmacological SUP was a routine procedure at the end of the 20th century, current guidelines for SUP in the critical care setting recommend against SUP in intensive care patients without risk factors as well as against stress ulcer prophylaxis in GHW patients [15][16][17][18]. Since ASM has long been considered safe and without significant side effects, critics of its widespread use were initially concerned by the cost produced by this practice [7,19]. However, over the last two decades, evidence has accumulated for potentially severe side effects of ASM, including bacterial gastroenteritis [20], acute interstitial nephritis [21], vitamin B deficiency [22], increased risk for COVID-19 [23], community and hospital-acquired pneumonia, dementia, osteoporosis and electrolyte disturbances, to name a few (for review, see Malfertheiner et al [24]).…”

Section: Introductionmentioning

confidence: 99%

Current Practice of Stress Ulcer Prophylaxis in Surgical Departments in Mecklenburg Western Pomerania, Germany

et al. 2021

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Background: Despite the growing concern over its potentially severe side effects and considerable economic burden, stress ulcer prophylaxis (SUP) is still frequently prescribed to patients in medical non-intensive care units. Recent data indicate that the situation is similar in surgical departments. Currently, data on the concepts within and regulation of routine SUP practice in surgical departments are sparse. The present study was designed to examine the current practice of SUP in Mecklenburg West Pomerania, Germany, and to identify possible reasons for the dissociation of medical literature and clinical practice. Methods: A questionnaire-based survey was conducted to elucidate current SUP practices in surgical departments of acute care hospitals in Mecklenburg Western Pomerania, Germany. Results: In most surgical departments (68%), a standard operating procedure (SOP) for SUP had not been developed. In departments with an existing SOP, 47.6% of responding medical staff members (MSM) with prescribing authority did not know of its existence. Of the MSMs aware of the existence of an SUP-SOP, only 42.9% indicated that they were familiar with its content. Critical re-evaluation of SUP indications upon transfer from the intensive care unit (ICU) to the general hospital ward (GHW) and before hospital discharge was performed frequently or systematically by only about half of the responding MSMs. Discussion: In the face of continued massive over-prescription of SUP in the perioperative routine, the development of easy-to-use local guidelines and their strict implementation in the clinical routine, as well as intensified medial education on this subject, may be effective tools to reduce acid-suppressive medication (ASM) associated side effects and economic burden.

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“…In England, the costs for antiulcer medications reached € 100,000,000 in 2006, with omeprazole as the most sold prescription. In the United States, esomeprazole sales alone surpassed € 4.5 billion in 2009, whereas the whole pharmacologic group constituted by the proton pump inhibitors was the third most sold group in the country (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

An economic analysis of inadequate prescription of antiulcer medications for in-hospital patients at a third level institution in Colombia

Machado‐Alba

Castrillón-Spitia

Londoño-Builes³

et al. 2014

Rev. esp. enferm. dig.

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Introduction:The prescription and costs of antiulcer medications for in-hospital use have increased during recent years with reported inadequate use and underused.Aim: To determine the patterns of prescription-indication and also perform an economic analysis of the overcost caused by the non-justified use of antiulcer medications in a third level hospital in Colombia.Materials and methods: Cross-sectional study of prescription-indication of antiulcer medications for patients hospitalized in "Hospital Universitario San Jorge" of Pereira during July of 2012. Adequate or inadequate prescription of the first antiulcer medication prescribed was determined as well as for others prescribed during the hospital stay, supported by clinical practice guidelines from the Zaragoza I sector workgroup, clinical guidelines from the Australian Health Department, and finally the American College of Gastroenterology Criteria for stress ulcer prophylaxis. Daily defined dose per bed/day was used, as well as the cost for 100 beds/day and the cost of each bed/drug. A multivariate analysis was carried out using SPSS 21.0.Results: 778 patients were analyzed, 435 men (55.9 %) and 343 women, mean age 56.6 ± 20.1 years. The number of patients without justification for the prescription of the first antiulcer medication was 377 (48.5 %), and during the whole in-hospital time it was 336 (43.2 %). Ranitidine was the most used medication, in 438 patients (56.3 %). The cost/month for poorly justified antiulcer medications was € 3,335.6. The annual estimated cost for inadequate prescriptions of antiulcer medications was € 16,770.0 per 100 beds.Conclusion: A lower inadequate prescription rate of antiulcer medications was identified compared with other studies; however it was still high and is troubling because of the major costs that these inadequate prescriptions generates for the institution.

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Analysis of Nonformulary Use of PPIs and Excess Drug Cost in a Veterans Affairs Population

Cited by 3 publications

References 17 publications

Economic Outcomes Associated with a Pharmacist-Adjudicated Formulary Consult Service in a Veterans Affairs Medical Center

Economic Outcomes Associated with a Pharmacist-Adjudicated Formulary Consult Service in a Veterans Affairs Medical Center

Current Practice of Stress Ulcer Prophylaxis in Surgical Departments in Mecklenburg Western Pomerania, Germany

An economic analysis of inadequate prescription of antiulcer medications for in-hospital patients at a third level institution in Colombia

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