A single-center cost analysis assessing a change in vasopressin formulation
Courtney E Kelly1,2, Christopher Miller1,2, William Darko1,2
1Department of Pharmacy, Upstate University Hospital, Syracuse, NY.
Summary
Reformulating vasopressin infusions significantly reduced waste and utilization by 38.7% at an academic medical center. This change in vasopressin concentration led to substantial cost savings, estimated between $222,625 and $308,857 annually.
Area of Science:
- Pharmacoeconomics
- Hospital Pharmacy Management
- Drug Formulation
Background:
- Standard vasopressin infusions at an academic medical center resulted in significant waste due to a high concentration (100 units/100 mL).
- Retrospective review showed only ~40% of dispensed vasopressin was administered, with preparations expiring before use within the 18-24 hour window.
Purpose of the Study:
- To describe cost savings achieved by reformulating standard vasopressin infusions to minimize waste.
- To evaluate the impact of changing vasopressin concentration on utilization and associated costs.
Main Methods:
- A new standard formulation of 20 units/100 mL for vasopressin continuous infusions was adopted.
- A pre-post study design was used to compare vasopressin utilization before and after the formulation change.
- Cost savings were calculated based on reduced drug utilization using 2017 and 2019 cost estimates.
Main Results:
- Vasopressin utilization decreased by 38.7% (from 21,900 to 8,480 units) post-reformulation.
- Cost savings ranged from $55,656.20 to $77,214.23 for the study period.
- Estimated annual cost savings from the new formulation range from $222,625 to $308,857.
Conclusions:
- This study is the first to report cost savings from reformulating vasopressin for continuous infusions.
- Similar formulation changes can be considered by other institutions to reduce costs.
- This approach complements existing cost-saving strategies like dose reduction and restriction policies.
More Related Videos
Related Concept Videos
00:56One-Compartment Open Model for IV Bolus Administration: Estimation of Clearance
185
Clearance is a key pharmacokinetic parameter that quantifies the volume of body fluid from which a drug is entirely removed within a specific time frame. It is crucial in assessing how a drug is eliminated from the body and has critical clinical applications.
In the one-compartment open model for intravenous (IV) bolus administration, clearance is estimated by dividing the elimination rate by the plasma drug concentration. This equation leverages the elimination rate constant and the apparent...
In the one-compartment open model for intravenous (IV) bolus administration, clearance is estimated by dividing the elimination rate by the plasma drug concentration. This equation leverages the elimination rate constant and the apparent...
185
01:24Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
69
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
69
01:15Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
67
Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
67
01:22Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence
54
Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
54
01:08Renal Drug Clearance: Comparison Between Renal Excretion Methods
410
Renal clearance is a critical parameter encompassing kidney filtration, secretion, and reabsorption processes. It is calculated using a specific equation to determine the rate at which the kidneys clear a drug.
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
410
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
64
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
64