While the Anesthesia Department is not responsible for paying for drug costs, the importance of these expenses to our facilities provide anesthesia teams with an opportunity to solidify and strengthen relationships by collaborating with the Hospital/ASC to contain and reduce drug costs as related to anesthesia.
It is understood that any optimization strategy must always put the patient’s health and well-being above all else.
Three areas to focus on for Optimization:
- Medication Utilization
- Protocol Development and Outcome Tracking
- Optimize Purchase Contracts and Inventory Management
- When possible, consider utilizing ‘old-line’, generic medications in place of newer, more expensive medications.
- Ex. Demerol/Morphine instead of new, short acting IV narcotics.
- Utilize lowest cost agent with similar clinical outcomes instead of “favorite med”.
- Utilize generic medications as opposed to Brand Name.
- Utilizing agents/medications that are ‘off-patent’.
- Eliminate drug wastage.
- Do not open med vials and ‘draw up’ medications for “possible need” (a common practice among anesthesia providers)…Keep vials handy for use if needed, but do not open unless necessary.
- Utilize agents that can be given with low flow gas rates (i.e. Desflurane).
Protocol Development and Outcome Tracking
- Develop protocols and standardize treatment/usage programs for most procedures, thereby providing drug usage and outcome monitoring
- Monitor and track outcomes with various providers to measure effectiveness of drug protocols across providers to determine optimum usage.
- Monitor and track outcomes to determine if lower-cost drug protocols in place of more expensive medications can be substituted to achieve similar or improved outcomes.
- Determine if medication synergies exist so that lower doses of all medications can be made.
- Standardized protocols allow for more efficient and cheaper purchasing of agents used in larger quantities as opposed to various providers utilizing different agents, which allows for bulk purchasing at generally lower cost.
Optimize Purchase Contracts and Inventory Management
- Establish purchasing contracts for discounted costs especially pertaining to medications utilized in ambulatory centers.
- Investigate GPO contracts, as opposed to facility contracts.
- “Just-in-time” inventory:
- Do not stock inventory with large reserves.
- Measure and track usage.
- Maintain 1-2 day inventory…having an adequate amount of medications on board for normal usage and eliminating large reserves.
- As mentioned in Section 2 above, track provider usage patterns to determine optimal usage of medications for various situations to develop protocols for common usage, which helps eliminate expiration of unused medication (waste).
- Manage formulary to optimize utilization of commonly used medications and eliminate wastage (minimize expiration of medications that are unused).
- Eliminate multiple drugs within same drug class.
While quality care and patient satisfaction will always be our first priority, collaborating with our Clients to help contain their costs will only strengthen the relationship and may in fact provide an advantage over another Anesthesia Provider.