Improvement in appropriate utilization of recombinant human erythropoietin pre- and post-implementation of a required order form

Tammy L. Burns, Brenna A. Ferry, Mark A. Malesker, Lee E. Morrow, Anne L. Bruckner, Debra L. Lee

Research output: Contribution to journalArticle

2 Scopus citations


BACKGROUND: Erythropoietin stimulating agents (ESAs) are high-cost medications that have a significant impact on many pharmacy budgets. Recently, ESAs have received stronger safety warnings and reimbursement has been curtailed by third-party payers including the Centers for Medicare and Medicaid Services. For these reasons, many hospitals are developing strategies to optimize their use. A required order form with acceptable indications and dosing was implemented at an academic medical center in an attempt to improve dosing and appropriate utilization of ESAs. OBJECTIVE: To determine whether implementation of a required order form increased appropriate use and/or decreased total utilization of recombinant human erythropoietin (rHuEPO). METHODS: This was a retrospective cohort study of rHuEPO utilization for 4 months pre- and 6 months post-implementation (April 2008-January 2009). RESULTS: Implementation of a required order form for rHuEPO resulted in significantly fewer patients receiving inappropriate doses of rHuEPO (51.3% vs 19.2%, p <0.001). The number of patients treated, adjusted to hospital census, was also reduced after implementation of the order form (0.003 vs 0.004 pts./average pt. days, p = 0.03). Annual spending for rHuEPO was reduced by 47% during 2008 despite an increased acquisition cost. CONCLUSIONS: Implementation of a required order form with evidence-based dosing recommendations can be an effective strategy to improve appropriate utilization of rHuEPO.

Original languageEnglish (US)
Pages (from-to)832-837
Number of pages6
JournalAnnals of Pharmacotherapy
Issue number5
StatePublished - May 1 2010


All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

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