American Journal of Health-System Pharmacy, Vol. 67, Issue 4, 295-299
Copyright © 2010 by American Society of Health-System Pharmacists

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Nemerovski, C. W. Articles by Stevenson, J. G. PubMed Articles by Nemerovski, C. W. Articles by Stevenson, J. G. Social Bookmarking                         What's this?

Note

Drug costs and utilization after implementation of a posaconazole prophylaxis protocol in adults with acute myelogenous leukemia

Carrie W. Nemerovski, Emily R. Mackler, Daryl D. DePestel, Curtis D. Collins, Kathleen S. Welch and James G. Stevenson

CARRIE W. NEMEROVSKI, PHARM.D., is Assistant Clinical Professor and Clinical Pharmacist—Cardiology, Department of Pharmacy Practice, Wayne State University, Detroit, MI; at the time of writing she was Cardiology Specialty Resident, University of Michigan Hospitals and Health Centers (UMHHC), Ann Arbor. EMILY R. MACKLER, PHARM.D., is Clinical Pharmacist, Hematology/Oncology; DARYL D. DEPESTEL, PHARM.D., is Clinical Associate Professor and Clinical Pharmacist, Infectious Diseases; and CURTIS D. COLLINS, PHARM.D., M.S., is Clinical Pharmacist, Infectious Diseases, UMHHC. KATHLEEN S. WELCH, M.S., M.P.H., is Statistical Consultant, University of Michigan Center for Statistical Consultation and Research, Ann Arbor. JAMES G. STEVENSON, PHARM.D., is Director of Pharmacy Services, UMHHC

Address correspondence to Dr. Nemerovski at the Department of Pharmacy Practice, Wayne State University, 259 Mack Avenue, Suite 4125, Detroit, MI 48201 (cnemerovski{at}wayne.edu).

Purpose. Drug costs and utilization after implementation of a posaconazole prophylaxis protocol in adults with acute myelogenous leukemia (AML) were studied. Methods. Adult patients who initiated induction or reinduction chemotherapy for the treatment of AML between December 1, 2006, and March 31, 2008, at a tertiary care hospital were included in this retrospective cohort study. Patients were divided into two groups: preprotocol (treated before June 1, 2007) and postprotocol (treated on or after June 1, 2007). Medical charts, including pharmacy and laboratory data, were reviewed for all patients. Outcomes measured included antifungal and antibacterial drug costs and utilization and total pharmacy costs. Results. A total of 66 patients were evaluated (33 in each group). Baseline characteristics, except patient age, were similar between groups. Each group incurred similar costs and utilized resources for similar periods of time as evidenced by similar lengths of stay, duration of neutropenia, and mortality. Antibacterial costs, total pharmacy costs, and other utilization outcomes were also similar between the two groups. Alterations to antifungal management strategy occurred more often in the postprotocol group (33% versus 58%, p = 0.048). Conclusion. Implementation of a posaconazole protocol did not significantly alter antifungal or antibacterial drug costs or utilization or total pharmacy costs. Prophylactic posaconazole was frequently changed to alternative antifungal therapy due to an adverse drug event, perceived lack of efficacy, avoidance of a drug interaction, or inability to tolerate oral intake. Index terms: Antifungals; Antiinfective agents; Costs; Drug interactions; Drug use; Leukemia; Mycoses; Pharmacy; institutional; hospital; Posaconazole; Protocols; Toxicity

 

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?