Evidence Based Practice and Quality Assurance
Background and Goal of Study: Some drugs used by anaesthetists are very expensive and greatly increase the cost of anaesthesia. Previous studies suggest cost awareness is limited (1,2). The aim of this study was to determine whether making drug prices available at point of use reduced costs.
Materials and Methods: In a 16 week prospective study, price information was supplied by 2 methods. A price gun was used to attach ‘point of use price stickers’ to the drug packaging. Price lists were also displayed on the theatre drug cupboard showing expensive drugs and cheaper alternatives. There were 2 equal measurement periods: a control period of drug use without cost information and a study period with cost information. Drug use was tracked by ascribe drug inventory system. A theatre book audit established activity (number of cases performed and total anaesthetic time). Weekly replicates of data were recorded to allow statistical analysis. Results calculated as mean cost in £ sterling (±SD) and compared with unpaired 2 tailed Student's t test (p < 0.05 significant).
Results and Discussions: Cost information led to a reduction in volatile costs of 40% with a decrease in sevoflurane use and an increase in isoflurane and desflurane use (Table 1). This is consistent with migration from the expensive drug to cheaper alternatives. There was no change in the use of propofol for infusion. Remifentanil cost reduced by almost 25% with no change in fentanyl and morphine use. No significant difference in theatre activity was demonstrated between the study periods.
Conclusion(s): A change in drug use patterns in response to cost information and a consequent reduction in drug spend is demonstrated.
1 Schlunzen L et al Acta Anaes Scand 1999;43:202-205.
2 Bailey C et al Anaesthesia 1993;48:906-909.