Faculty Articles

Development and Implementation of Customized Intravenous to Oral Conversion Protocol: Cost-Saving Analysis

Publication Title

Value in Health

Publisher

ISPOR

ISSN

1524-4733

Publication Date

5-1-2016

Keywords

cost, intravenous, oral, protocol, savings

Abstract

Objectives

Properly switching medication’s route of administration from intravenous (IV) to oral (PO) using equipotent doses, proved to be associated with multiple positive outcomes. With $21k-$450k yearly cost savings per institution, many hospitals have implemented therapeutic interchange programs to facilitate proper conversion. The primary objective of this project is to develop and implement a customized IV to PO conversion protocol at the University Medical Center Rizk Hospital (UMC-RH). Additional objective includes evaluation of the associated potential cost savings from hospital and patient perspectives.

Methods

An extensive literature research was conducted, current practice guidelines were identified. Additionally, the UMC-RH formulary was reviewed to develop patients and medications inclusion criteria. A five-week intervention was carried out, the percentage of patients receiving adequate treatment (via appropriate route of administration) was the primary endpoint. Secondary economic endpoints included the estimated cost saving per patient per day for each of the study medications and the estimated cost savings per dose for proper therapy conversion over the project duration. All data analyses were conducted using SPSS for Windows version 23.0. A p-value of less than 0.5 was considered significant for all analyses.

Results

43 patients were included in this study. Over a one month period, 40% of patients received ciprofloxacin IV when criteria to receive the PO formulation was met. All patients eligible for PO levofloxacin were receiving IV formulation. 16.67% and 66.67% of patients receiving metronidazole and esomeprazole, respectively, were on inappropriate therapy. Despite the small sample size, a one-day earlier conversion from IV to PO medication showed significant cost savings for each of the study medications. The total inpatient expenditures were significantly reduced(p 0.03).

Conclusions

Development of a customized IV to PO conversion protocol confirmed positive impact. An earlier switch to PO therapy, when appropriate, decreased the percentage of inadequate therapy, and provided cost-savings for hospital and patients.

DOI

10.1016/j.jval.2016.03.879

Volume

19

Issue

3

First Page

PA272

Disciplines

Medicine and Health Sciences | Pharmacy and Pharmaceutical Sciences

Link to Full Text
Peer Reviewed

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