GRP-078 Guideline For Albumin Use: Effect on Cost Saving

Abstract

Background Albumin has been widely used in clinical practise. While some of these indications are supported by the results of randomised studies, others are based only on clinical experience and have not been proved in prospective studies. Efforts should be made to define the indications for albumin use, so that patients gain the maximum benefit from its administration. Purpose To evaluate the cost saving obtained by the implementation of a guideline for albumin use in a 737-bed hospital. Materials and Methods Retrospective study that compared albumin use in two periods: July–September 2012 vs. July–September 2011. In June 2012 the guideline for albumin use was distributed to the medical staff. Physicians were requested to complete a form for each albumin order indicating the type and amount of albumin, the clinical service, and the indication for use. Albumin use data and costs were obtained from pharmacy service management system (SAP®) and were tabulated using the Excel® software. ResultsThe total amount of albumin ordered during the study period was 29.360 g (€63,246) vs. 53.195 g (€108,617) for the same period during 2011, which means a reduction of 45%. In terms of cost, the saving obtained amounted to €45,371 (58%). The albumin use by specialty had also changed; a major decrease in use of albumin was observed for Anaesthesiology 4,000 g (75%), General Surgery 3,080 g (65%), Nephrology 4,900 g (64%), Internal Medicine 3,860 g (56%), Haematology 1,410 g (53%) and Digestive 1,400 g (30%). On the other hand, Haemodialysis significantly increased its use of albumin to 2,805 g (65%), although within the approved indication of plasmapheresis. Conclusions An albumin use guideline with restrictions focused on albumin prescriptions had suficient efficacy to reduce consumption and save cost. In our hospital guideline the cost of implementation decreased a 58% (€181,484 per year). No conflict of interest.

Effect of hospital-wide interventions to optimize albumin use in a tertiary hospital

“…In order to improve the rational use of albumin, different strategies have been designed, implemented and studied in hospitals. Among them, educational and administrative interventions, such as institutional and local guidelines, have reduced inappropriate albumin use …”

“…Among them, educational and administrative interventions, such as institutional and local guidelines, have reduced inappropriate albumin use. [12][13][14][15][16] Albumin utilization studies in our country have revealed that albumin is used inappropriately in 26%-95% of cases. National audits and studies have shown the economic burden of the irrational use of albumin.…”