Cost reduction associated with restriction policy on dispensing intravenous esomeprazole in lebanon

Oral Ppi VS IV Ppi in Hospitalized Patient

Objectives: Of this study have been produced in order to promote effective use of proton pump inhibitors (PPIs) and (H2RAs) histamine II receptor antagonists at AL-Zahraa University Hospital (ZUH) in Lebanon. The aims: Of the study are to ensure PPIs use is limited to situations where there is indicated and there is a clear evidence of benefit, in order to decrease the cost when possible without affecting the patient’s clinical outcome. Setting: Medical and surgical in-patients floors at AL-Zahraa University Hospital (ZUH) were used for this study, which include 57medical and 43 surgical beds. Methods: In this study 100 patients files were reviewed for appropriate IVPPIs uses in two separate time intervals, over six months period started on January 1st, 2016 and ended on June 30th, 2016 and divided into two equal separate time intervals, pre implementation and post implementation of restriction dispensing policy, in order to determine the proper indication and the cost impact of restriction procedure. The main outcomes measure the cost difference between pre and post restriction periods. Results: During the pre-restriction period, the majority of IVPPIs vials were dispensed to patients able to tolerate oral medications with no proper indications to IVPPIs use, the daily consumption of IVPPIs were 48 vials (960 $) in the pre-restriction period as compared to only 2 vials (40$) in the post restriction period, therefore the associated daily cost was reduced from 960$ to 40$. Conclusion: This study highlighted the impact of proper use of PPIs based on implantation of the dispensing authorization restriction form of IVPPIS use which based on the international protocols for peptic ulcer drugs uses, leading to statistically significant in hospital patient’s daily cost reduction by 24 folds.