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Courtney E Kelly, Christopher Miller, William Darko, Greg Cwikla, Bryan Mogle, Julianna Featherly, Rebecca Marcinak, Luke A Probst, Robert Seabury, A single-center cost analysis assessing a change in vasopressin formulation, American Journal of Health-System Pharmacy, Volume 78, Issue 13, 1 July 2021, Pages 1238–1243, https://doi.org/10.1093/ajhp/zxab153
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Abstract
Cost savings achieved at an academic medical center by reformulating the institution’s standard vasopressin infusions to reduce waste are described.
After a retrospective review of vasopressin utilization over a 4-month period revealed that only approximately 40% of dispensed vasopressin units were actually administered to patients, pharmacy leaders determined that the institution’s standard vasopressin concentration for continuous infusions (100 units in 100 mL of sodium chloride 0.9% injection) was resulting in substantial waste, as many infusion preparations were not needed within the 18- to 24-hour expiration window. A concentration of 20 units/100 mL was adopted as the new standard formulation for vasopressin continuous infusions, with use of alternative concentrations allowed on a restricted basis. A pre-post study to assess the impact of the formulation change indicated a 38.7% decrease in vasopressin utilization (from 21,900 to 8,480 units) relative to utilization in a retrospective sample of patients who received vasopressin infusions prior to the formulation change. This reduced utilization equated to a cost decrease of $55,656.20 (as calculated on the basis of 2017 cost estimates) or $77,214.23 (as calculated on the basis of 2019 cost estimates) for the time period collected. It was estimated that the new formulations could yield annual cost savings ranging from $222,625 to $308,857.
To our knowledge, this is the first description of cost savings following a change in formulation of vasopressin for continuous infusions. Other institutions could consider employing a similar approach in addition to the previously reported cost-saving interventions, such as lower vasopressin starting doses and vasopressin restriction policies.
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