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 Citations (Scopus)

Abstract

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
Pages (from-to)832-837
Number of pages6
JournalAnnals of Pharmacotherapy
Volume44
Issue number5
DOIs
StatePublished - May 2010

Fingerprint

Erythropoietin
Health Insurance Reimbursement
Costs and Cost Analysis
Centers for Medicare and Medicaid Services (U.S.)
Budgets
Censuses
Cohort Studies
Retrospective Studies
Safety

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Improvement in appropriate utilization of recombinant human erythropoietin pre- and post-implementation of a required order form. / Burns, Tammy L.; Ferry, Brenna A.; Malesker, Mark A.; Morrow, Lee E.; Bruckner, Anne L.; Lee, Debra L.

In: Annals of Pharmacotherapy, Vol. 44, No. 5, 05.2010, p. 832-837.

Research output: Contribution to journalArticle

@article{f3c84bc6b2cb42519be805710baa25f4,
title = "Improvement in appropriate utilization of recombinant human erythropoietin pre- and post-implementation of a required order form",
abstract = "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.",
author = "Burns, {Tammy L.} and Ferry, {Brenna A.} and Malesker, {Mark A.} and Morrow, {Lee E.} and Bruckner, {Anne L.} and Lee, {Debra L.}",
year = "2010",
month = "5",
doi = "10.1345/aph.1M563",
language = "English",
volume = "44",
pages = "832--837",
journal = "Annals of Pharmacotherapy",
issn = "1060-0280",
publisher = "Harvey Whitney Books Company",
number = "5",

}

TY - JOUR

T1 - Improvement in appropriate utilization of recombinant human erythropoietin pre- and post-implementation of a required order form

AU - Burns, Tammy L.

AU - Ferry, Brenna A.

AU - Malesker, Mark A.

AU - Morrow, Lee E.

AU - Bruckner, Anne L.

AU - Lee, Debra L.

PY - 2010/5

Y1 - 2010/5

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=77951611320&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77951611320&partnerID=8YFLogxK

U2 - 10.1345/aph.1M563

DO - 10.1345/aph.1M563

M3 - Article

C2 - 20371758

AN - SCOPUS:77951611320

VL - 44

SP - 832

EP - 837

JO - Annals of Pharmacotherapy

JF - Annals of Pharmacotherapy

SN - 1060-0280

IS - 5

ER -