Effect of a pharmacy-based cost-containment program on cimetidine costs and use

Area of Science:

• Pharmacoeconomics
• Clinical Pharmacy Practice
• Drug Utilization Review

Background:

• Over-prescribing of cimetidine was a concern at the University of California at San Diego Medical Center.
• Appropriate drug utilization is crucial for patient safety and healthcare cost management.

Purpose of the Study:

• To describe a program designed to curb the over-prescribing of cimetidine.
• To evaluate the impact of pharmacist-led interventions on cimetidine utilization and associated costs.

Main Methods:

• Development and implementation of cimetidine use guidelines.
• Physician education and patient monitoring by pharmacists using a specialized documentation form.
• Intervention by pharmacists to recommend changes when cimetidine use deviated from guidelines.

Main Results:

• Cimetidine hydrochloride injection use decreased by 49% within the initial intervention period (September 30 to December 6, 1985).
• Estimated annual cost savings ranged from +12,000 to +16,000.
• Cimetidine use increased after guideline enforcement ceased, but declined again upon reinstitution of pharmacist review.

Conclusions:

• Pharmacist-led drug utilization review programs can effectively reduce inappropriate prescribing of medications like cimetidine.
• Periodic pharmacist intervention and reinforcement are necessary to maintain appropriate prescribing patterns and achieve sustained cost savings.
• The study highlights the vital role of clinical pharmacists in optimizing drug therapy and managing healthcare costs.