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Budget Cuts? Managing the Pulmonary Arterial Hypertension Medication Formulary While Being Cost Conscious for Your Institution

Laura Duvall


Namita Sood


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Conference: 2014 International PHA Conference and Scientific Sessions

Release Date: 06.22.2014

Presentation Type: Abstracts

File Download: 2014 Conference Abstract - Laura Duvall II

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Background: Rising medical costs along with changes in reimbursement for services has forced many hospitals to reevaluate their operating costs and financial structures. In February 2013, a consultant group evaluating The Ohio State University Wexner Medical Center’s pharmacy department in conjunction with hospital leadership, recommended that the pharmacy department needed to save 8M dollars in the next 15 months on their drug budget.

Methods: A “deep-dive” into all areas of medication cost was conducted. Initially, reports were obtained to identify both high-use and high-cost medications. In our institution, the pulmonary arterial hypertension (PAH) medications as a group made the TOP 10 for associated high-cost. A focused team was formed to evaluate all of our PAH medications with regards to Contracting, Inventory Management, Formulary Management, and Waste/Repackaging.

Results: Reporting at cost per year - in contracting we were able to save (projected) $44K by changing the way we purchase treprostinil sodium injection. For inventory management we were able to save (projected) $37K by doing a thorough evaluation of medication use versus par levels and by taking package sizes into account with purchasing. In formulary management we have consciously decided not to put some products on formulary if the package sizes or costs are not favorable for institutional use. In these cases policies have been developed to address use of a patient’s home medication in place of a formulary alternative. Finally, with regards to waste/repackaging we were able to save (projected) $65K-$95K by recommending a new process for initiation and use of epoprostenol IV.

Conclusions: A very detailed evaluation of your institution’s current pharmacy processes can result in a large cost savings. We were able to project cost savings of over $140K with minimal changes to our policies and procedures. Additionally, the changes that were put in place are sustainable for years to come, as we strive to continue to be cost conscious in the future.

Type: Clinical Science