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.

Abstract

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.

Citation

Langley, T., Lacey, J., Johnson, A., Newman, C., Khare, M., Skelly, R., Subramanian, D., Norwood, M., Sturrock, N., & Fogarty, A. W. (2018). An evaluation of a price transparency intervention for two commonly prescribed medications on total institutional expenditure: a prospective study. Future Hospital Journal, 5(3), 198-202. https://doi.org/10.7861/futurehosp.5-3-198

• Journal Article Type: Article
• Acceptance Date: Mar 23, 2018
• Online Publication Date: Oct 4, 2018
• Publication Date: Oct 1, 2018
• Deposit Date: May 25, 2018
• Publicly Available Date: Oct 1, 2018
• Journal: Future Hospital Journal
• Print ISSN: 2055-3323
• Electronic ISSN: 2055-3331
• Publisher: Royal College of Physicians
• Peer Reviewed: Peer Reviewed
• Volume: 5
• Issue: 3
• Pages: 198-202
• DOI: https://doi.org/10.7861/futurehosp.5-3-198
• Keywords: cost feedback, antibiotics, inhaled corticosteroids
• Public URL: https://nottingham-repository.worktribe.com/output/921460
• Publisher URL: http://futurehospital.rcpjournal.org/content/5/3/198
• Additional Information: This paper has been accepted for publication by the Future Hospital journal and is due for publication in October 2018.; ; Copyright is retained by the Royal College of Physicians
• Contract Date: May 25, 2018