In this episode, I’ll discuss strategies to reduce the cost of using vasopressin.
After a period of unstable supply, IV vasopressin was given approval by the FDA in 2014 to be sold under the brand name Vasostrict by a single manufacturer.
While this change went a long way to stabilizing the supply of vasopressin, it drastically increased the cost. Vasopressin went from a generic medication with an insignificant cost to a branded product with a brand-name-sized price tag.
This change was partially balanced when the ACLS guidelines removed vasopressin as an optional recommendation in place of a dose of epinephrine for cardiac arrest however pharmacy medication budgets were still significantly impacted by the 40-fold increase in vasopressin acquisition cost.
One 545 bed hospital has recently published their experience with implementing cost savings initiatives for vasopressin.
The hospital implemented two strategies to reduce vasopressin costs.
First, they transitioned from an IV vasopressin formulation of 50 units/250 mL to a formulation of 20 units/100 mL.
Second, they removed vasopressin from automated dispensing cabinets.
The authors then conducted a before:after analysis to assess these changes.
The formulation change resulted in an average cost savings of $366.42 per patient. This savings was due to using on average 100 units of vasopressin per patient and avoiding the 10 units of waste each time a 50 unit infusion was made from three 20 unit vials. If the change was applied to 40 patients per month the hospital estimates an over $175,000 annual cost savings.
The removal of vasopressin from the ADC was judged to have prevented waste from doses that were prepared but thought missing and obtained again from the ADC by nursing. Assuming this avoided 9 bags being wasted per month, this was a further $60,000 in annual cost savings.
The authors concluded that:
Changing the vasopressin formulation and removing it from ADCs resulted in a significant cost savings to the health system.
These changes are relatively easy and should not be controversial, so if your hospital has not done so already, consider implementing these simple cost saving measures.
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