Category: Professional Posters
Purpose: Prednisolone is a corticosteroid, commonly prescribed in the hospital setting for a variety of indications, often as a short term treatment. Enteric coated (EC) prednisolone was the preparation routinely stocked and utilised by hospital in-patients, even when EC was not specifically prescribed. Film coated (FC) prednisolone was supplied for in-patients with swallowing difficulties. There is no conclusive evidence that the use of EC prednisolone reduces the risk of peptic ulceration.1 Furthermore patients on high dose or long term corticosteroids are often prescribed a separate agent for gastro-protection. EC prednisolone is five times more expensive than FC prednisolone.
Methods: In February 2019, EC prednisolone was replaced by FC prednisolone on all in-patient ward stock lists. Only patients admitted on EC prednisolone were maintained on the EC preparation, including the heart /lung transplantation patients who are routinely managed with EC prednisolone.
Results: In a two month period prior to the changeover (November and December 2018) 24,200 units of EC prednisolone were purchased (Cost=€ 2,388) and 1,600 units of FC prednisolone were purchased (Cost = € 28), resulting in a total spend of € 2,416 in a two month period.
In the two month period directly after the changeover 1,800 units of EC prednisolone (Cost = € 174) and 21,400 units of FC prednisolone were purchased (Cost = € 377), resulting in a total spend of € 551 in a two month period.
This constitutes savings of €1,865 in a two month period, a 77.2% reduction in total spend on prednisolone.
Although we note slightly more prednisolone (n =2600 units) purchased in the two month period before the changeover versus after, the data is still comparable.
Conclusion: The growth in medicines costs is a global challenge. Spending on hospital medicines is increasing at a greater pace than any other type of healthcare expenditure, thus organisational governance of medicines expenditure is crucial. Our hospital has demonstrated a simple change from EC prednisolone to FC prednisolone was possible, with no reported adverse effects. There will be continued significant cost savings associated with the switch.