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Impact of pharmacist recommendations on the cost of drug therapy in ICU patients at a Malaysian hospital

Zaidi ST, Hassan Y, Postma MJ, Ng SH

Pharm World Sci, 2003 Dec;25(6):299-302.
PMID: 14689820

To analyse clinical pharmacists interventions in the ICU of the Penang General Hospital (Penang, Malaysia) and to assess the pharmaco-economic impact of these interventions.

Matched MeSH terms: Pharmacy Service, Hospital/economics
Achieving cost-efficient management of drug supply via economic order quantity and minimum-maximum stock level

Dewi EK, Dahlui M, Chalidyanto D, Rochmah TN

Expert Rev Pharmacoecon Outcomes Res, 2020 Jun;20(3):289-294.
PMID: 31203686 DOI: 10.1080/14737167.2019.1633308

BACKGROUND: A good drug inventory planning system is important for an efficient budgeting, procurement, and cost control of drugs. When stagnant drugs in the inventory are too much, wastage due to expired and spoiled drugs could occur. These will not only cause loss of income but could also jeopardize healthcare service delivery.
RESEARCH DESIGN AND METHODS: This study aimed to determine the most efficient and effective management of stagnant and shortage drugs by comparing three pharmacy logistic methods; the economic order quantity (EOQ), minimum-maximum stock level (MMSL), and the traditional consumption of drug inventory, at RA Basoeni Hospital, Mojokerto. Drug inventory was analyzed to calculate the opportunity loss, opportunity cost, and proportions of both stagnant and shortage drugs.
RESULTS: We found that EOQ and MMSL performed best for control of stagnant drugs and shortage drugs, respectively. Both methods had proved as effective pharmacy logistic planning. In addition, EOQ produced the lowest opportunity cost for stagnant drugs besides the lowest opportunity loss for shortage drugs.
CONCLUSION: The study concluded that EOQ is the most effective and efficient method to manage stagnant and shortage drugs at hospital pharmacy.

Matched MeSH terms: Pharmacy Service, Hospital/economics*
Fulltext Economic burden of hypoglycemia for type II diabetes mellitus patients in Malaysia

Aljunid SM, Aung YN, Ismail A, Abdul Rashid SAZ, Nur AM, Cheah J, et al.

PLoS One, 2019;14(10):e0211248.
PMID: 31652253 DOI: 10.1371/journal.pone.0211248

This study mainly aims to identify the direct cost and economic burden of hypoglycemia for patients with type II diabetes mellitus in Malaysia. A cross-sectional study explored the cost incurred for hypoglycemia among patients admitted to University Kebangsaan Malaysia Medical Centre (UKMMC). The study covered patients aged 20-79 years hospitalized with a primary diagnosis of ICD-10 hypoglycemia and discharged between January 2010 and September 2015 according to the casemix database. A costing analysis was done through a step-down approach from the perspective of health providers. Cost data were collected for three levels of cost centers with the help of a hospital-costing template. The costing data from UKMMC were used to estimate the national burden of hypoglycemia among type II diabetics for the whole country. Of 244 diabetes patients admitted primarily for hypoglycemia to UKMMC, 52% were female and 88% were over 50 years old. The cost increased with severity. Managing a hypoglycemic case requires five days (median) of inpatient stay on average, with a range of 2-26 days, and costs RM 8,949 (USD 2,289). Of the total cost, 30% related to ward (final cost center), 16% to ICU, and 15% to pharmacy (secondary-level cost center) services. Considering that 3.2% of all admissions were hypoglycemia related, the total annual cost of hypoglycemia care for adult diabetics in Malaysia is estimated at RM 117.4 (USD 30.0) million, which translates to 0.5% of the Ministry of Health budget. Hypoglycemia imposes a substantial economic impact even without the direct and indirect cost incurred by patients and other cost of complications. Diabetic management needs to include proper diabetic care and health education to reduce episodes of hypoglycemia.

Matched MeSH terms: Pharmacy Service, Hospital/economics*
Fulltext Factors Influencing the Total Inpatient Pharmacy Cost at a Tertiary Hospital in Malaysia: A Retrospective Study

Aljunid SM, Ali Jadoo SA

Inquiry, 2018 2 14;55:46958018755483.
PMID: 29436248 DOI: 10.1177/0046958018755483

The steady growth of pharmaceutical expenditures is a major concern for health policy makers and health care managers in Malaysia. Our study examined the factors affecting the total inpatient pharmacy cost (TINPC) at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). In this retrospective study, we used 2011 administration electronic prescriptions records and casemix databases at UKMMC to examine the impact of sociodemographic, diagnostic, and drug variables on the TINPC. Bivariate and multivariate analyses of the factors associated with TINPC were conducted. The mean inpatient pharmacy cost per patient was USD 102.07 (SD = 24.76). In the multivariate analysis, length of stay (LOS; B = 0.349, P < .0005) and severity level III ( B = 0.253, P < .0005) were the primary factors affecting the TINPC. For each day increase in the LOS and each increase of a case of severity level III, there was an increase of approximately USD 11.97 and USD 171.53 in the TINPC per year, respectively. Moreover, the number of prescribed items of drugs and supplies was positively associated with the TINPC ( B = 0.081, P < .0005). Gender appears to have affected the TINPC; male patients seem to be associated with a higher TINPC than females (mean = 139.55, 95% confidence interval [CI]: 112.97-166.13, P < .001). Surgical procedures were associated with higher cost than medical cases (mean = 87.93, 95% CI: 61.00-114.85, P < .001). Malay (MYR 242.02, SD = 65.37) and Chinese (MYR 214.66, SD = 27.99) ethnicities contributed to a lower TINPC compared with Indian (MYR 613.93, SD = 98.41) and other ethnicities (MYR 578.47, SD = 144.51). A longer hospitalization period accompanied by major complications and comorbidities had the greatest influence on the TINPC.

Matched MeSH terms: Pharmacy Service, Hospital/economics*
Impact of a renal drug dosing service on dose adjustment in hospitalized patients with chronic kidney disease

Hassan Y, Al-Ramahi RJ, Aziz NA, Ghazali R

Ann Pharmacother, 2009 Oct;43(10):1598-605.
PMID: 19776297 DOI: 10.1345/aph.1M187

Appropriate drug selection and dosing for patients with chronic kidney disease (CKD) is important to avoid unwanted drug effects and ensure optimal patient outcomes.

Matched MeSH terms: Pharmacy Service, Hospital/economics