ANALYSIS OF AMOUNT, EXPENDITURES AND INDICATIONS OF DRUG AND BLOOD PRODUCT PRESCRIPTIONS AT SURGICAL INTENSIVE-CARE UNITS

Analysis of indication-related drug prescription patterns is of partic ular interest with regard to rising costs of the health service being also reflected in higher expenditures for drugs at the University Hosp ital of the Friedrich-Schiller-University Jena. This is especially imp ortant at ICU's, since treatments in patients with acute or chronic mu ltiorgan failure are very expensive. Over a period of 4 months in 1994 the indication-related drug consumption of 2 surgical ICU's of the Un iversity of Jena has been recorded and analyzed using a notebook-PC. T he total costs of these drugs and blood products, which caused 80% of total costs in the last year, came up to 1,144,773 DM for 465 patients . Nearly two thirds of the recorded expenditures were caused in patien ts with severe trauma or with acute bleeding. The 10 leading substance s (antithrombin III, human albumin 20%, prothrombine complex, etc.) re present 67% of total costs including blood products, antibiotics/antim ycotics and IgM enriched intravenous immunoglobulins. Therefore, the i ndications of these drugs in particular have been further investigated . During and after the study the results have been discussed with the treating medical staff leading to new therapy recommendations. Until t he end of 1994 a remarkable cost saving could already be achieved for some drugs by more critical and purposeful use providing same high sta ndard of medical treatment. Blood products have to be included into an alyses of indication-related drug administration on the meaning of hig h costs, difficulties of accurate indication, and possibly undesired s ide-effects. However, medical and ethical aspects, e.g. minimizing of side-effects, have to take priority over pharmacoeconomical considerat ions especially in intensive care medicine.