Pharmacy management strategies for responding to hospital reimbursement changes

Pharmacy management strategies for responding to hospital reimbursement changes are described. On the assumption that the Medicare prospective pricing system and other fixed-rate reimbursement systems will force hospital pharmacists to reduce their operating expenses, several methods of reducing drug use and drug costs, rather than payroll costs, are described: (1) reduced price per unit purchased, (2) increased use of bid prices, (3) decrease in the size and dollar value of drug inventory, (4) drug formulary restrictions, (5) prescribing sanctions, (6) physician education on the relative costs of alternate therapies, (7) drug-use review, (8) use review applied to drug serum assays, (9) controlled access of drug industry representatives to hospital physicians, and (10) dispensing and drug-distribution efficiencies. Physician resistance to pharmacist intervention in drug prescribing and drug-use review should be anticipated; however, pharmacists should expect the support of hospital administrators in efforts to control drug use.