Advertisement

Pharmaceutisch Weekblad

, Volume 13, Issue 6, pp 248–253 | Cite as

Cost of hospital antimicrobial chemotherapy

A method for global cost calculation
  • Inge C. Gyssens
  • Christianne A. Lennards
  • Yechiel A. Hekster
  • Jos W. M. Van der Meer
Articles

Abstract

We will describe the method of cost-identification analysis, which was performed in a Dutch hospital during a review of antimicrobial drugs usage. In the present Dutch hospital budget system, in-patients' drug costs generate no revenues. Efforts to diminish drug costs result in financial benefit for the institution. To maximize cost containment, efforts are to be directed to all cost components. We chose wholesale purchase prices of antimicrobial drugs and national prices for salaries and hospital costs. Global cost comparison shows the most cost effective system of intravenous administration. Push injection is the most economic way to administer intravenous drugs which do not require dilution or prolonged infusion time. For stable solutions, such as metronidazole, ready-to-infuse bags are the most economic system. A global cost calculation is listed for commonly used antimicrobial drugs for in-patients. A cost comparison is given for vancomycin CP and teicoplanin, two antistaphyloccocal drugs, which are probably equieffective. The result of global cost comparison contributes to the decision to include new drugs into the hospital formulary or to replace older ones.

Keywords

Antibiotics Cost and cost analysis Drug utilization Financial management Hospitals Infusions, intravenous 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Steenhoek A. Prophylactic antibiotics and the hospital budget: controversy for patients and hospital financial strategies? Pharm Weekbl [Sci] 1990;12(6A):300–2.Google Scholar
  2. 2.
    Hekster YA, Barrett CW. Formulary antibiotic surveillance program. J Pharm Clin 1987;6:335–42.Google Scholar
  3. 3.
    Rapp RP, Bannon CL, Bivins BA. The influence of dose frequency and agent toxicity on the cost of parenteral antibiotic therapy. Drug Intell Clin Pharm 1982;16:935–8.PubMedGoogle Scholar
  4. 4.
    Tanner DJ. Cost containment of reconstituted parenteral antibiotics: personnel and supply costs associated with preparation, dispensing, and administration. Rev Infect Dis 1984;6(Suppl 4):S924–37.PubMedGoogle Scholar
  5. 5.
    Veterans Administration Pharmacy Service Study Group. Variable cost per dose of preparing and administering small-volume cephalosporin admixtures. Am J Hosp Pharm 1984;41:2624–34.Google Scholar
  6. 6.
    Weinstein MC, Read JL, MacKay DN, et al. Costeffective choice of antimicrobial therapy for serious infections. J Gen Intern Med 1986;1:351–63.PubMedGoogle Scholar
  7. 7.
    Eisenberg JM, Glick H, Koffer H. Pharmacoeconomics: Economic evaluation of Pharmaceuticals. In: Strom BL, ed. Pharmacoepidemiology. New York: Churchill Livingstone, 1989:325–50.Google Scholar
  8. 8.
    Gladen HE. Computer modelling antibiotic therapy costs. Impact of therapeutic range. Drugs 1988;35(Suppl 2):208–13.PubMedGoogle Scholar
  9. 9.
    Averbuch M, Weintraub M, Nolte F. Gentamicin blood levels: ordered too soon and too often. Hosp Formul 1989;24:598–612.PubMedGoogle Scholar
  10. 10.
    Anonymous. Richtlijnen Wijziging Declaratie Structuur 1988 [Guidelines for changes in declaration structure]. COTG Vademecum. COTG Utrecht. Alphen a/d Rijn: Samsom, 1989.Google Scholar
  11. 11.
    Rowland M. Clinical pharmacokinetics of teicoplanin. Clin Pharmacokinet 1990;18(3):184–209.PubMedGoogle Scholar
  12. 12.
    Anonymous. Eerste interimrapport van de Commissie Verantwoordelijkheid verpleegkundigen in algemene ziekenhuizen [First report of the Committee on Responsibility of Nurses in General Hospitals]. [Verslagen Adviezen Rapport nr. 51]. Leidschendam: Staatstoezicht op de Volksgezondheid, Ministerie van Welzijn, Volksgezondheid en Cultuur, 1982:28–9.Google Scholar
  13. 13.
    Anonymous. Tweede rapport van de Commissie Verantwoordelijkheid verpleegkundigen in algemene ziekenhuizen [Second report of the Committee on responsibility of Nurses in General Hospitals]. Leidschendam: Staatstoezicht op de Volksgezondheid, Ministerie van Welzijn, Volksgezondheid en Cultuur, 1985:49–50.Google Scholar

Copyright information

© Royal Dutch Association for Advancement of Pharmacy 1991

Authors and Affiliations

  • Inge C. Gyssens
    • 1
  • Christianne A. Lennards
    • 2
  • Yechiel A. Hekster
    • 3
  • Jos W. M. Van der Meer
    • 1
  1. 1.Department of Internal MedicineUniversity Hospital NijmegenHB Nijmegenthe Netherlands
  2. 2.Economic and Financial DepartmentUniversity Hospital Nijmegenthe Netherlands
  3. 3.Department of Clinical PharmacyUniversity Hospital Nijmegenthe Netherlands

Personalised recommendations