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Flolan® and Veletri® Medication Use and Cost Analysis Audit at an Academic Medical Center

Shea Liput

Laura Duvall


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Conference: 2017 PH Professional Network Symposium

Release Date: 10.06.2017

Presentation Type: Abstracts

File Download: 2017 PHPN Abstract 1001

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Abstract presented at the 2017 PH Professional Network Symposium held in Bethesda, Md. on October 5-7, 2017


In 2012, The Ohio State University Wexner Medical Center (OSUWMC) began an initiative called “Create the Future Now” which aimed to adapt the organization to the rapidly changing healthcare environment. This endeavor allowed the health-system to become more value-driven while maintaining optimal patient outcomes. One of the pillars of this initiative is financial innovation to reduce healthcare expenditures in favor of using the most cost-effective therapeutic modalities while maintaining efficacy for the patient.

Prior to the Create the Future Now initiative, OSUWMC only had Flolan® on formulary. The yearly cost to the pharmacy department to carry the medication and diluent products was ~$250,000.

Veletri® was added to the formulary at OSUWMC on June 4, 2013. It was added with the agreement that all new epoprostenol starts would be on Veletri®. Flolan® was kept on formulary for use only by patients currently maintained on this therapy.


This retrospective utilization and cost analysis review evaluated all Flolan® orders from July 1, 2011 through June 30, 2012 (FY12) and July 1, 2015 through June 30, 2016 (FY16) as well as all Veletri® orders from FY16 for any patient admitted to OSUWMC. The data utilized from these reports included quantity of drug in milliliters (mL) and dose in milligrams (mg) to determine the amount of drug used. The number of patients receiving epoprostenol (either brand) was also obtained.


The estimated cost associated with the use of Flolan® in FY12 was ~$250,000 for 654 bags of medication and a total of 5467 mg of drug. In FY16, the cost associated with the use of Flolan® was reduced to ~$70,000 which was associated with 126 bags and 1,680 mg of drug, and the cost of Veletri® was ~$100,000 which was comprised of 390 bags and a total of 2586 mg of drug. The combined cost of both brands in FY16 was ~$170,000 with a total of 516 bags and 4,266 mg of epoprostenol product.


The data demonstrates a cost savings of ~$80,000 with the addition of Veletri® to the formulary however it must be noted that there were 138 fewer bags and a total of 1,201 fewer milligrams of drug dispensed. It is notable that, in FY12, there were five more patients receiving an epoprostenol product than in FY16. Furthermore, the patient population is small and inpatient length of admission may be variable based on severity of disease. Despite the limitations, the results confirm the benefit of having Veletri® on formulary in addition to Flolan®. Although this analysis provides an estimate rather than an exact amount, the cost-savings is significant. This data, we believe, is useful and informative with regards to the success of a pharmacy-based cost-savings initiative.