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Therapeutic-interchange program for oral histamine H2-receptor antagonists
S L Chase1, A M Peterson, C J Wordell
1Drug Use Policy and Clinical Services, Thomas Jefferson University Hospital (TJUH), Philadelphia, PA 19107-5098, USA.
Summary
A hospital implemented a therapeutic interchange program for oral histamine H2-receptor antagonists, achieving significant cost savings and high compliance. The program successfully promoted cost-effective drug choices through physician support and education.
Area of Science:
- Pharmacoeconomics
- Health Services Research
- Drug Utilization
Background:
- Hospitals often face challenges in controlling drug expenditures.
- Previous attempts to promote a preferred oral histamine H2-receptor antagonist (cimetidine) were unsuccessful.
- Drug manufacturers' pricing strategies can influence formulary decisions.
Purpose of the Study:
- To describe the implementation and outcomes of a therapeutic interchange (TI) program for oral histamine H2-receptor antagonists.
- To evaluate the program's impact on drug selection, cost savings, and compliance.
- To identify key factors contributing to the success of the TI program.
Main Methods:
- A therapeutic interchange program was implemented, switching formulary status of oral H2 antagonists.
- Nizatidine was initially preferred, later replaced by famotidine based on cost-effectiveness.
- Extensive staff education, compliance monitoring, and physician engagement were utilized.
Main Results:
- The program achieved 97% compliance within two months of implementation.
- First four months yielded over $40,000 in cost savings.
- The program was successfully adapted to a new preferred agent (famotidine) in 1997.
Conclusions:
- Therapeutic interchange programs can effectively reduce costs for oral histamine H2-receptor antagonists.
- Physician support, provider education, and compliance monitoring are critical for TI program success.
- Flexibility in adapting to changing drug costs and market dynamics is essential.
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