EVALUATION OF COST MINIMIZATION STRATEGIES OF ANESTHETIC DRUGS IN A TERTIARY CARE HOSPITAL

A survey was undertaken to compare anaesthetic drug expenditures over a three-year period, to evaluate the impact of strategies offered to c urtain continuously rising drug costs. Suggestions to control rising e xpenditures were based primarily on education of staff and residents r egarding drug costs, emphasizing rational use of the more expensive dr ugs, and minimizing drug wastage. To assess the impact of these measur es, a review of annual hospital budgets, global pharmacy expenditures, and anaesthetic drug expenditures was conducted for the period 1991 t o 1993. Both absolute and proportional costs of anaesthetic drugs were compared, by year according to six major classes: opioid analgesics ( OA), muscle relaxants (MR) inhalational anaesthetic drugs(INH), intrav enous anaesthetic drugs (IV), local anaesthetic drugs (LA) and a categ ory labelled other drugs (OTH). In addition, the utilization patterns and unit price changes were compared for each drug for the periods 199 1-92, and 1992-93. Total hospital drug costs increased from $7.1M to $ 8.5M over the three years. During the same period, the cost of anaesth etic drugs decreased from $379K to $361K, despite an augmentation in a nnual case load from 12,507 to 13,076 surgical procedures. For the ent ire survey period, the mean cumulative anaesthetic drug cost was 4.6% of the pharmacy budget, or 0.24% of the hospital budget. Analysis by d rug class revealed a $51K decrease in expenditures on OA, due to decre ased utilization of fentanyl and alfentanil, and a decrease in the pri ce of fentanyl. The increased expenditure on INH drugs was primarily d ue to an increase in acquisition costs. The introduction of the new iv anaesthetic drugs ($34K increase) had minimal effect on overall drug expenditures. We conclude that the implementation of simple measures s uch as the education of anaesthesia personnel regarding drug costs, an d decreasing drug wastage, can be an effective means of controlling dr ug expenditures, at a time when new drugs and techniques are being int roduced The pharmacoeconomic benefits of such efforts must consider ov erall cost-effectiveness, including the duration and quality of recove ry.