Megan Van Berkel Patel, BCCCP, PharmD, FCCM
Clinical Pharmacy Specialist
n/a
Disclosure information not submitted.
Summer Sizemore, PharmD
Clinical Pharmacist
Erlanger Medical Center
Chattanooga, Tennessee, United States
Disclosure information not submitted.
Breanna Carter, BCCCP, BCPS, PharmD
Erlanger Health System, Tennessee
Disclosure information not submitted.
Emily Garrett, PharmD, BCPS
Clinical Pharmacist
Erlanger Medical Center, United States
Disclosure information not submitted.
Title: Adjusting vasopressin availability and formulation: A cost-savings initiative
Introduction: The generic rebranding of vasopressin resulted in an increase in medication costs requiring many healthcare systems to consider cost-savings strategies. As a result, the vasopressin formulation at our institution was changed from 50 units per 250ml to 20 units per 100ml, continuing to follow a nationally recommended concentration of 0.2 units/ml. Additionally, vasopressin was removed from the automated dispensing cabinets (ADCs).
Methods: This retrospective chart review occurred at a 545-bed academic medical center with 97 adult ICU beds. Adult patients were included if a continuous vasopressin infusions was administered and no patients were excluded. One month periods were assessed before (December 2019) and after (April 2021) changing the formulation in January 2021. Duplicate bags compounded by pharmacy and at the bedside were also assessed in the pre-group. The primary outcome is the estimated annual cost savings due to a formulation change with a secondary outcome as estimated annual cost savings due to removal from the ADC. Each vasopressin 20 unit/2ml vial cost $183.21 at the time of the study. Data is reported through a descriptive analysis.
Results: In the pre-group, 39 patients were included requiring an average of two bags each costing $1099.26 per patient. In the post-group, 41 patients were included requiring an average of four bags costing $732.84 per patient. For the primary outcome, an average of approximately 40 patients per month requiring continuous infusion vasopressin would lead to an annual cost savings of $175,881.60. In the secondary outcome, nine duplicate bags were made in the pre-group from removal of vasopressin from the ADCs and pharmacy compounding that were not charted against causing waste. Removal from the ADCs to avoid duplicate compounding is estimated to result in additional cost savings of $59, 360.04. The combined estimated annual cost saving from both initiatives is $235, 241.64.
Conclusion: Changing the vasopressin formulation to eliminate waste during compounding and removing it from ADCs to avoid duplicate compounding resulted in a significant cost-savings to the health system.