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Antiulcer prescribing program in a state correctional system

M R Keith1, D M Cason, D K Helling

  • 1Texas Department of Criminal Justice-Institutional Division (TDCJ-ID), Huntsville 77340.

The Annals of Pharmacotherapy
|June 1, 1994
PubMed
Summary
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A formulary antiulcer agent prescribing program successfully reduced medication costs and corrected prescribing patterns. The initiative achieved significant annual savings without negatively impacting patient care.

Area of Science:

  • Pharmacoeconomics
  • Health Services Research
  • Drug Utilization

Background:

  • A large correctional system with 40 units and 4 pharmacies dispenses approximately 4000 medication orders daily.
  • Medication orders are managed through a mainframe computer system.

Purpose of the Study:

  • To describe the development and impact of a formulary antiulcer agent prescribing program.
  • To evaluate the cost-effectiveness and clinical outcomes of the program.

Main Methods:

  • A drug use evaluation (DUE) identified overuse of antiulcer agents (cimetidine, ranitidine, sucralfate) in terms of dosage and duration.
  • A prescribing program was implemented to reduce dosages to maintenance levels after eight weeks.
  • Follow-up DUE assessed antiulcer agent use, expenditures, and patient outcomes seven months post-implementation.

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Main Results:

  • Mean daily dosage of histamine2-receptor antagonists decreased significantly (e.g., cimetidine from 694 to 454 mg).
  • Mean duration of therapy reduced from 14 to 10 months, with a decrease in drug interactions.
  • Projected annual savings of $327,273 were achieved through a reduction of 24,461 dosage units dispensed monthly.

Conclusions:

  • The formulary program effectively reduced costs and aligned prescribing with established criteria.
  • No discernible negative impact on patient care was observed.
  • The pharmacy and therapeutics committee successfully sponsored a cost-saving initiative.