Characterization Of Injectable Medication Errors In The Hospital Setting: A Retrospective Database Analysis

Abstract

The Pharmacy and Therapeutic Committee in the hospital planned to study the aggregate medicine use in the hospital. After implementation of the Essential Drug List (EDL) 2011, it was important to know the consumption and cost contributed by each pharmaceuticals in the list so that further revisions could be done on the list annually. METHODS: The study was conducted for one year using Always Better Control (ABC) analysis of pharmaceuticals in the EDL. Pharmaceuticals from the EDL were categorized for A (70%) B (20%) C (10%) categories. The calculations were done from a period of January 11, 2011 to January 11, 2012 using the data from the hospital billing database. RESULTS: The total annual drug expenditure (ADE) was Rs. 2,61,78,251. Out of 311 pharmaceuticals in the list, 47 (15%) were in A group, 60 (19%) were in B group and the remaining 204 (66%) were in C group. In the A group 45% of the pharmaceuticals were belong to ATC category J (Antimicrobials). Out of the top 10 pharmaceuticals, the costlier one was Anti D Immunoglobulin costing Rs. 1995. But it came on sixth position as the consumption was lesser than the other ones in the top. The first one was Lopinavir-Ritonavir combination with an annual cost of 13, 76529. Insulin was on fourth position with an annual expenditure just short of one million Indian Rupees. The top 10 include 3 antivirals and 2 anti-bacterial preparations showing the high consumption and costs of the anti-microbial agents. The least unit cost in the A category was Rs. 0.18 for ferrous sulphate -folic acid combination. CONCLUSIONS: Antimicrobilas consumed major resources of the charity hospital. Control on antimicrobial prescription with updated protocols and adoption of government free supply of anti-retroviral drugs will substantially reduce the hospital budget on medicines.