Abstract

Background: Hematological therapeutic agents, i.e. anticoagulants and hematopoetic agents are widely used for hospitalized patients without consideration of costs. The current analysis was performed to determine the relative expenditures of this class of therapeutic agents.

Hypothesis: Hematological agents constitute a significant portion of inpatient pharmaceutical costs.

Methods: A retrospective single center analysis was performed using data obtained on all inpatient pharmaceutical costs at LSUHSC from June 1, 2005 to May 31, 2006. The data was obtained directly from the inpatient pharmacy and was divided into various therapeutic classes and agents. The data was provided as the dollar cost of the agents and percentage of each agent and class calculated. Hematopoietic agents, i.e. G-CSF, GM-CSF, pegfilgrastim, epoetin alfa, and the various anticoagulant drugs were combined to define our hematological therapeutic class. Sera, including e.g. win rho and cytogam, and antineoplastic agents were not included in the hematological therapeutic class. Blood products and the cost of administering agents were not included in this analysis.

Results: Hematopoietic and anticoagulant agents constituted 6.8% and 6.4% of the total inpatient pharmaceutical costs, respectively. The 13.2% for hematological therapeutic agents was second in cost only to antibiotics, which comprised 17.4% of total inpatient pharmaceutical costs. By comparison, sera, and antineoplastic agents comprised 10.2% and 6.3% of total cost, respectively. Taken together the hematological therapeutic class plus sera and antineoplastic agents demonstrates that this class of agents is the most costly with 29.7% of total cost.

Conclusions: Hematological agents make up a significant percentage of inpatient pharmaceutical costs. LSUHSCS is probably not much different from other public and private hospitals in terms of relative inpatient pharmaceutical cost by therapeutic class. This information is not meant to dissuade practitioners, institutions, or third party payers from the use of hematological agents for such cost may be more than offset by decreased length of hospital stay, decreased blood product infusions, and decreased use of other medications. Rather, this analysis may provide an incentive to review the use of hematological agents in terms of medical indications, cost effectiveness, and therapeutic options. Whether or not a trend exists for increasing hematological costs relative to other agents remains to be seen and requires additional analysis including the costs of administration.

To Dale Potts & Chuck Everton-Thanks!

Inpatient Pharmacy Costs 6/01/05 – 5/31/06

Class%Cost
% = % of total inpatient pharmacy costs 
Sera (e.g. octagam, win rho) 10.18% $1,320,235.00 
Hematopoietic Agents 6.84% $887,364.00 
Anticoagulants 6.38% $827,457.00 
Antineoplastic Agents 6.32% $818,916.00 
Penicillins 5.86% $759,579.00 
Miscellaneous B-Lactam Antibiotics 3.53% $458,120.00 
Miscellaneous Therapeutic Agents 3.34% $432,743.00 
Miscellaneous Antibacterials 3.09% $401,058.00 
Opiate Agonists 2.95% $382,509.00 
Blood Derivatives 2.83% $367,045.00 
Quinolones 2.46% $319,496.00 
Cephalosporins 2.42% $314,266.00 
Dihydropyridines 2.42% $313,847.00 
Antipsychotic Agents 2.37% $307,500.00 
Replacement Preparations 2.04% $264,625.00 
Remaining classes (each<2% total) 36.94% $4,788,703.00 
Total 100% $12,963,463.00 
Class%Cost
% = % of total inpatient pharmacy costs 
Sera (e.g. octagam, win rho) 10.18% $1,320,235.00 
Hematopoietic Agents 6.84% $887,364.00 
Anticoagulants 6.38% $827,457.00 
Antineoplastic Agents 6.32% $818,916.00 
Penicillins 5.86% $759,579.00 
Miscellaneous B-Lactam Antibiotics 3.53% $458,120.00 
Miscellaneous Therapeutic Agents 3.34% $432,743.00 
Miscellaneous Antibacterials 3.09% $401,058.00 
Opiate Agonists 2.95% $382,509.00 
Blood Derivatives 2.83% $367,045.00 
Quinolones 2.46% $319,496.00 
Cephalosporins 2.42% $314,266.00 
Dihydropyridines 2.42% $313,847.00 
Antipsychotic Agents 2.37% $307,500.00 
Replacement Preparations 2.04% $264,625.00 
Remaining classes (each<2% total) 36.94% $4,788,703.00 
Total 100% $12,963,463.00 

Disclosure: No relevant conflicts of interest to declare.

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