An evaluation of a price transparency intervention for two commonly prescribed medications on total institutional expenditure: a prospective study

Importance: Providing cost feedback has been demonstrated to decrease demand from clinicians. Objective: We tested the hypothesis that providing the cost of drugs to clinicians would modify total expenditure. Design: A prospective study design with a step-wise intervention. Setting/Participants:...

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Main Authors: Langley, Tessa, Lacey, Julia, Johnson, Anthony, Newman, Clive, Khare, Milind, Skelly, Rob, Subramanian, Deepak, Norwood, Mark, Sturrock, Nigel, Fogarty, Andrew W.
Format: Article
Language:English
Published: Royal College of Physicians 2018
Subjects:
Online Access:https://eprints.nottingham.ac.uk/52016/
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author Langley, Tessa
Lacey, Julia
Johnson, Anthony
Newman, Clive
Khare, Milind
Skelly, Rob
Subramanian, Deepak
Norwood, Mark
Sturrock, Nigel
Fogarty, Andrew W.
author_facet Langley, Tessa
Lacey, Julia
Johnson, Anthony
Newman, Clive
Khare, Milind
Skelly, Rob
Subramanian, Deepak
Norwood, Mark
Sturrock, Nigel
Fogarty, Andrew W.
author_sort Langley, Tessa
building Nottingham Research Data Repository
collection Online Access
description Importance: Providing cost feedback has been demonstrated to decrease demand from clinicians. Objective: We tested the hypothesis that providing the cost of drugs to clinicians would modify total expenditure. Design: A prospective study design with a step-wise intervention. Setting/Participants: Individuals who were admitted to the XXX from November 2013 to November 2015 under the physicians. Intervention: The cost of all antibiotics and inhaled corticosteroids was added to the electronic prescribing system. Main outcomes: The weekly cost for antibiotics and inhaled corticosteroids in the intervention period compared to baseline. Results: Mean weekly expenditure on antibiotics per patient decreased by £3.75 (95% confidence intervals CI: -6.52 to -0.98) after the intervention from a pre-intervention mean of £26.44, and then slowly increased subsequently by £0.10/week (95%CI: +0.02 to +0.18). Mean weekly expenditure on inhaled corticosteroids per patient did not substantially change after the intervention (-£0.03, 95%CI: -0.06 to -0.01 after the intervention from a pre-intervention mean of £5.29 per person). New clinical guidelines for inhaled corticosteroids were associated with a decrease in weekly expenditure. Conclusions and relevance: Provision of cost feedback resulted in no sustained change in institutional expenditure. However, clinical guidelines have potential for modifying clinical prescribing behaviour.
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spelling nottingham-520162018-05-25T08:25:01Z https://eprints.nottingham.ac.uk/52016/ An evaluation of a price transparency intervention for two commonly prescribed medications on total institutional expenditure: a prospective study Langley, Tessa Lacey, Julia Johnson, Anthony Newman, Clive Khare, Milind Skelly, Rob Subramanian, Deepak Norwood, Mark Sturrock, Nigel Fogarty, Andrew W. Importance: Providing cost feedback has been demonstrated to decrease demand from clinicians. Objective: We tested the hypothesis that providing the cost of drugs to clinicians would modify total expenditure. Design: A prospective study design with a step-wise intervention. Setting/Participants: Individuals who were admitted to the XXX from November 2013 to November 2015 under the physicians. Intervention: The cost of all antibiotics and inhaled corticosteroids was added to the electronic prescribing system. Main outcomes: The weekly cost for antibiotics and inhaled corticosteroids in the intervention period compared to baseline. Results: Mean weekly expenditure on antibiotics per patient decreased by £3.75 (95% confidence intervals CI: -6.52 to -0.98) after the intervention from a pre-intervention mean of £26.44, and then slowly increased subsequently by £0.10/week (95%CI: +0.02 to +0.18). Mean weekly expenditure on inhaled corticosteroids per patient did not substantially change after the intervention (-£0.03, 95%CI: -0.06 to -0.01 after the intervention from a pre-intervention mean of £5.29 per person). New clinical guidelines for inhaled corticosteroids were associated with a decrease in weekly expenditure. Conclusions and relevance: Provision of cost feedback resulted in no sustained change in institutional expenditure. However, clinical guidelines have potential for modifying clinical prescribing behaviour. Royal College of Physicians 2018-03-23 Article PeerReviewed application/pdf en https://eprints.nottingham.ac.uk/52016/1/Drug%20cost%20rewrite%20revision.pdf Langley, Tessa, Lacey, Julia, Johnson, Anthony, Newman, Clive, Khare, Milind, Skelly, Rob, Subramanian, Deepak, Norwood, Mark, Sturrock, Nigel and Fogarty, Andrew W. (2018) An evaluation of a price transparency intervention for two commonly prescribed medications on total institutional expenditure: a prospective study. Future Hospital Journal . ISSN 2055-3331 (In Press) cost feedback antibiotics inhaled corticosteroids
spellingShingle cost feedback
antibiotics
inhaled corticosteroids
Langley, Tessa
Lacey, Julia
Johnson, Anthony
Newman, Clive
Khare, Milind
Skelly, Rob
Subramanian, Deepak
Norwood, Mark
Sturrock, Nigel
Fogarty, Andrew W.
An evaluation of a price transparency intervention for two commonly prescribed medications on total institutional expenditure: a prospective study
title An evaluation of a price transparency intervention for two commonly prescribed medications on total institutional expenditure: a prospective study
title_full An evaluation of a price transparency intervention for two commonly prescribed medications on total institutional expenditure: a prospective study
title_fullStr An evaluation of a price transparency intervention for two commonly prescribed medications on total institutional expenditure: a prospective study
title_full_unstemmed An evaluation of a price transparency intervention for two commonly prescribed medications on total institutional expenditure: a prospective study
title_short An evaluation of a price transparency intervention for two commonly prescribed medications on total institutional expenditure: a prospective study
title_sort evaluation of a price transparency intervention for two commonly prescribed medications on total institutional expenditure: a prospective study
topic cost feedback
antibiotics
inhaled corticosteroids
url https://eprints.nottingham.ac.uk/52016/