Rising drug costs are putting increasing pressure on healthcare systems, highlighting the need for rational and responsible medicines use, according to a new study looking at cost-effective and sustainable drug use in hospitals.
Conducted at Erasmus University Medical Centre in Rotterdam, Netherlands, this research developed a systematic framework known as the 8-Step Efficiency Model to identify and implement medicines cost-saving strategies while maintaining high standards of patient care.
The Model was developed through collaboration between clinical pharmacists, physicians and business analysts.
Some 39 high-cost drugs, which accounted for 57% of national drug expenditure in 2021, were assessed using the Model, with strategies explored for implementing cost-effectiveness. Evidence-based practices guided the development of this framework, with input from a broad range of stakeholders.
From the initial analysis, cost-saving initiatives focused on 27 agents. For instance, switching anti-tumour necrosis factor therapies to biosimilars resulted in savings of 7–7.5% per patient annually, totalling €320,000. A further €10,000 was saved by dose-rounding to the nearest full vial of infliximab.
Additionally, the authors developed a strategy for intravenous immunoglobulin (IVIg) weight-based dosing. This database analysis comparing IVIg plasma concentrations across various body mass index groups will potentially reduce costs by €670,000 annually.
‘The model presented in this study can guide clinicians in identifying, developing, and implementing novel strategies for cost-effective drug use at the hospital level,’ the researchers said.
They also highlighted how the Model could help reduce the environmental footprint by promoting more sustainable drug use practices.
Hospital pharmacists can apply the 8-Step Efficiency Model at their own institutions to identify cost-optimisation opportunities, reduce drug waste and ultimately enhance sustainability in clinical practice.
A three-stage implementation framework, developed in parallel to the Model, was crucial for helping hospital pharmacists and other stakeholders integrate the Model effectively.
The authors recommended that future research should focus on interventional pharmacoeconomic trials which evaluate the impact of initiatives like this Model. They also call for increased collaboration between healthcare providers, insurers and pharmaceutical companies to accelerate the adoption of cost-effective drug use strategies across healthcare systems.
Reference
Zietse M, et al. Cost-Effective and Sustainable Drug Use in Hospitals: A Systematic and Practice-Based Approach. Appl Health Econ Health Policy. 2024 Dec 19. doi: 10.1007/s40258-024-00937-6.
