During a hospital stay, patients who have respiratory ailments such as chronic obstructive pulmonary disease or asthma may need Ipratropium Bromide (Atrovent®) or Albuterol metered-dose inhaler drugs which relax muscles in the airways and increase air flow to the lungs. While this medication must be used regularly to be effective, the cost of inhalers is expensive—Albuterol costs $56, while Atrovent® costs $359.
For calendar year 2016, 1,401 Albuterol inhalers and Atrovent inhalers were dispensed, costing $205,104 annually.
Realizing this, Everett Hood, director, Respiratory, Pulmonary and Neurophysiology Services, Ben Taub and Quentin Mease hospitals, saw an opportunity to save Harris Health System money by changing the way the drugs are dispensed—cease using inhalers and offer the same medication in liquid form through a nebulizer.
The cost savings were staggering. The liquid form of the same medications costs $0.168, costing $4,712.06 annually. Changing the way the medication was dispensed resulted in Harris Health saving $201,000 annually. In addition, it reduced approximately 23 minutes of pharmacy staff time per current MDI order—that’s 672 hours of pharmacy time per year. And in the end, patients receive their medication treatment quicker.
Hood worked with Jerry Wong, clinical pharmacy specialist, Pharmacy and the Pharmacy Information Technology Department, to obtain the costs of medications and reports on inhaler dispensing information. In reviewing the data, he recognized Harris Health had an opportunity for significant savings.
In addition to the expense, the amount of waste was exorbitant at 87 percent. While inhalers are good for 30 days, the average length of stay for patients is four days and many inhalers were discarded upon discharge. Additionally, some inhalers had to be re-dispensed for inpatients during their stay.
“When you look at the data, it’s amazing what you learn,” Hood says. “By switching to liquid medications, we were able to decrease hospital medication costs, inhaler waste and save process time of these medications within pharmacy, thereby increasing efficiency.”